Objective:To analyze the intraoperative hemodynamic management by hypotension prediction index(HPI)in one patient underwent robot-assisted laparoscopic cystectomy,and to provide the reference for anesthesia monitoring and hemodynamic management in the similar major surgery.Methods:The clinical data,intraoperative hemodynamic data,usage and dosage of vasoactive drugs,and clinical outcomes of one patient underwent robot-assisted laparoscopic cystectomy with HPI-guided intraoperative hemodynamic management were retrospectively analyzed,and the relevant literatures were reviewed.Results:The patient,a 72-year-old female,was admitted due to macroscopic hematuria for 5 months accompanied by dysuria for 3 months.The cystoscope results showed a 7 cm× 7 cm× 5 cm mass on the right side of the bladder trigone and a 4 cm × 3 cm × 3 cm mass near the bladder neck.The positron emission tomography/computed tomography(PET/CT)results showed thickening of the right posterior bladder wall with high metabolism,and the preliminary diagnosis was bladder malignancy.After preoperative anesthesia evaluation,the robot-assisted laparoscopic cystectomy was planned.After entering the operating room,the routine monitoring was conducted,and the monitor equipped with HPI software was used to guide intraoperative hemodynamic management.After routine anesthesia induction,the tracheal intubation was performed by video laryngoscope.The patient experienced intraoperative hypotension(IOH)for six times,the cumulative time of mean arterial pressure(MAP)＜65 mmHg was 13.7 min,accounting for 4.40％of the anesthesia duration,and the time-weighted average of MAP＜65 mmHg was 0.28 mmHg.The time range with HPI≥85 roughly overlapped with and included the period of MAP＜65 mmHg.At 146 time points with HPI≥85,the MAP remained greater than 65 mmHg at 68.5％(100/146)of the points.At 47 time points with MAP＜65 mmHg,HPI≥85 occurred at 97.9％(46/47)of the points.On the first postoperative day,the patient's hypersensitive cardiac troponin I was＜0.01 μg·L-1,and no perioperative adverse events occurred.The patient was discharged on the eighth day.Conclusion:HPI can promptly and accurately predict the occurrence of IOH in the patients undergoing robot-assisted laparoscopic cystectomy.The use of HPI-based hypotension correction strategies during surgery can maintain the time-weighted average of MAP＜65 mmHg at a lower level.

Objective To study the mechanism of Chufeng Yisun Decoction in the treatment of corneal injury based on network pharmacology combined with experimental validation.Methods The active components and targets of Chufeng Yisun Decoction were obtained from TCMSP and TCMID databases.Related targets of corneal injury were searched through GeneCards,OMIM,TTD and NCBI-Gene databases.Chinese materia medica-active components-key target network was established.The main active components of Chufeng Yisun Decoction for the treatment of corneal injury were analyzed.The core targets were predicted through PPI network.CCK-8 method was used to screen the optimal concentration of serum containing Chufeng Yisun Decoction for promoting cell growth.Western blot was used to detect autophagy related protein expressions of LC3,LAMP1 and ERK2.Results The main active components of Chufeng Yisun Decoction in the treatment of corneal injury were kaempferol,wogonin,quercetin and paeoniflorin.The core targets were AKT1,TP53,MAPK1,JUN and TNF.The intervention of serum containing Chufeng Yisun Decoction on human corneal fibroblasts could increase the LC3I/LC3II ratio and LAMP1 protein expression,while decrease ERK2 protein expression,which was consistent with the prediction of network pharmacology.Conclusion Chufeng Yisun Decoction treats corneal injury through multiple components,targets and pathways.The mechanism of promoting autophagy therapy for corneal injury is achieved by down-regulating the expression of ERK2 and up-regulating the expression of LC3 and LAMP1.

This study aims to obtain two whole-genome sequences of enzootic nasal tumor virus of goats(ENTV-2)from Anhui Province and analyzed the genetic diversity of ENTV-2 gene.Nasal secretion samples and blood samples of six goats with enzootic nasal adenocarcinoma(ENA)were collected from a goat farm in Anhui Province.The total RNA was extracted by the TRIzol method.The DNA interference was removed by the two-step reverse transcription.The ENTV-2 was detec-ted by PCR.Then,two positive samples were selected and five pairs of primers were used to ampli-fy the whole-genome sequences of ENTV-2.After sequencing and splicing,two sequences were up-loaded to the database for comparative analysis with the sequences in the NCBI database.Finally,the genetic evolution tree was constructed.ENTV-2 was detected in the nasal secretion samples,but not in the blood of the six ENA goats.The ENTV-2 genes were approximately 7 400 bp in length,named ENTV-2AH1(DDBJ accession no.:LC762616)and ENTV-2AH2(DDBJ accession no.:LC762617),respectively.Two sequences showed 99.2％and 99.1％homology with the Fujian strain(ENTV-2FJ)and Guangxi strain(ENTV-2-DA0),respectively.They were in the same evo-lutionary branch.In this study,two whole-genome sequences of ENTV-2 were obtained in Anhui for the first time,which can help to further study the genetic diversity of ENTV-2 in China.

Objective·To investigate the safety and feasibility of early goal-directed mobilization in the recovery of gastrointestinal function after pancreaticoduodenectomy.Methods·The non-contemporaneous controlled studies were conducted.Subjects who underwent pancreaticoduodenectomy were included.From Sep 2022 to May 2023,forty patients were selected as the control group,and forty patients were selected from June 2023 to February 2024 as the experimental group.The general clinical data of the two groups were collected.The control group was treated with the nursing routine after pancreaticoduodenectomy,and there were no specific requirements for the time and goal of early activity.The experimental group had daily activity goals established for early mobilization,which were performed by the patients and their families,while the rest of their care was identical to that of the control group.The main index of effectiveness evaluation was the time of first flatus and first defecation,and the secondary indexes included the time of first getting out of bed,the time of oral drinking,the time of the gastric tube removal,and the postoperative levels of K+,Na+,and Cl-on the 3rd day of the postoperative period.Safety evaluations included chyle leak,postoperative pancreatic fistula,biliary leak and delayed gastric emptying,postoperative hemorrhage,unplanned reoperation,unplanned extubation,falls and death.Results·There was no statistically significant difference in the general clinical data of the patients in the 2 groups.After the implementation of early goal-directed mobilization,the time of first flatus was advanced from(3.95±1.68)d to(2.88±0.91)d(t=-3.560,P=0.001),and the time of first defecation was advanced from(4.90±1.61)d to(3.80±1.30)d(t=-3.352,P=0.001).The time of first getting out of bed was advanced from(5.18±1.77)d to(2.30±0.88)d(t=-9.205,P＜0.001),and the time of oral drinking was advanced from(4.10±1.89)d to(2.73±1.20)d(t=-3.883,P＜0.001).Significant differences were also observed in postoperative day 3 Na+(t=-2.745,P=0.008)and Cl-(t=-2.033,P=0.045)levels.Conclusion·Early goal-directed activity programs are safe and effective in promoting the recovery of gastrointestinal function after pancreaticoduodenectomy.

Objective:To explore the application effect of medical waste management system based on B/S architecture in medical waste disposal.Methods:Select a third-class hospital in Yantai for continuous quality improvement of medical waste disposal, and verify the feasibility of the medical waste management system through key indicators such as medical waste related theoretical knowledge, medical waste disposal efficiency, and medical waste disposal management process standardization rate. Through monitoring indicators and result feedback evaluation, it is judged whether the medical waste management system has positive significance for the improvement of medical waste disposal.Results:Taking the adoption of medical waste management system as the node, a five-month comparison before and after was conducted to monitor key indicators such as medical waste disposal efficiency and standardized rate of medical waste disposal management processes. The daily error rate of medical waste classification was reduced from 6.00% to 1.33%, the daily confusion rate of working procedures was reduced from 6.67% to 0.67%, the time delay rate of medical waste disposal was reduced from 7.33% to 2.00%, and the standardized rate of medical waste disposal management processes was increased from 93.33% to 100%. All the data were statistically significant ( P<0.05). Conclusions:Since the operation of the medical waste management system, through the top-down management and control of the administrator and with its unique time retrieval function, the time delay problem of the previous manual management has been greatly improved. The classification management function of medical waste solves the criticism of unclear and chaotic classification of medical waste. The department retrospective function enables the division of responsibilities for medical waste work to be clear, and improves the work efficiency. The construction of medical waste management system based on B/S architecture provided a new information approach for the scientific management of medical waste and a reference for the scientific and effective management of clinical medical waste.

The lung is one of the most common sites for cancer metastasis. Collagens in the lung provide a permissive microenvironment that supports the colonization and outgrowth of disseminated tumor cells. Therefore, down-regulating the production of collagens may contribute to the inhibition of lung metastasis. It has been suggested that miR-29 exhibits effective anti-fibrotic activity by negatively regulating the expression of collagens. Indeed, our clinical lung tumor data shows that miR-29a-3p expression negatively correlates with collagen I expression in lung tumors and positively correlates with patients' outcomes. However, suitable carriers need to be selected to deliver this therapeutic miRNA to the lungs. In this study, we found that the chemotherapy drug cisplatin facilitated miR-29a-3p accumulation in the exosomes of lung tumor cells, and this type of exosomes exhibited a specific lung-targeting effect and promising collagen down-regulation. To scale up the preparation and simplify the delivery system, we designed a lung-targeting liposomal nanovesicle (by adjusting the molar ratio of DOTAP/cholesterol-miRNAs to 4:1) to carry miR-29a-3p and mimic the exosomes. This liposomal nanovesicle delivery system significantly down-regulated collagen I secretion by lung fibroblasts in vivo, thus alleviating the establishment of a pro-metastatic environment for circulating lung tumor cells.

To Track the source of the infection through an investigation of a clustering of coronavirus disease 2019(COVID-19), and provide scientific basis and Strategy for the effective control of the aggregated epidemic situation of COVID-19. Field epidemiological method was used to survey the cases and related close contacts in a family clustering epidemic of COVID-19 in Dandong city of Liaoning Province. We obtained survey data for a descriptive analysis.Real time RT-PCR technique was used to detect 2019-nCoV nucleic acid in samples collected from cases and related close contacts combined with serum specific antibody detection. A total of 3 confirmed cases and 2 asymptomatic infection cases were discovered in the clustering epidemic, with 34 close contacts.Of eight close family contacts visiting from other province, one patient was on the same flight as the confirmed case, and her antibody IgG was positive. The family clustering was caused by past infection case who visited her friend through Wuhan from other provinces to local area.

To Track the source of the infection through an investigation of a clustering of coronavirus disease 2019(COVID-19), and provide scientific basis and Strategy for the effective control of the aggregated epidemic situation of COVID-19. Field epidemiological method was used to survey the cases and related close contacts in a family clustering epidemic of COVID-19 in Dandong city of Liaoning Province. We obtained survey data for a descriptive analysis.Real time RT-PCR technique was used to detect 2019-nCoV nucleic acid in samples collected from cases and related close contacts combined with serum specific antibody detection. A total of 3 confirmed cases and 2 asymptomatic infection cases were discovered in the clustering epidemic, with 34 close contacts.Of eight close family contacts visiting from other province, one patient was on the same flight as the confirmed case, and her antibody IgG was positive. The family clustering was caused by past infection case who visited her friend through Wuhan from other provinces to local area.