Chronic post-surgical pain (CPSP) is a common long-term complication following lung surgery. Its high incidence significantly impacts patients’ quality of life and functional recovery, and imposes a substantial socioeconomic burden. This consensus aims to systematically establish a standardized integrated Chinese and Western medicine diagnostic and treatment framework for chronic post-lung surgery pain (CPLSP). Based on the latest domestic and international evidence-based medical research and multidisciplinary clinical experience, the working group comprehensively elaborates on core issues regarding CPLSP, including its definition, epidemiology, pathogenesis, clinical assessment, Western medical treatment, traditional Chinese medicine (TCM) treatment, and integrated strategies. The consensus emphasizes a patient-centered approach, adhering to the principles of multimodality, individualization, and stepwise management, highlighting the synergistic advantages of integrating Chinese and Western medicine throughout the entire perioperative management cycle encompassing "perioperative anti-inflammation, acute analgesia, and chronic rehabilitation." Through systematic literature retrieval and evidence integration, a total of 9 core recommendations were established to provide scientifically sound and clinically practical guidance.

BACKGROUND:The anterior cruciate ligament has unique nonlinear mechanical properties under a complex physiological loading environment.Elastin is an important contributor to the mechanical properties of the anterior cruciate ligament,but its mechanical response to the anterior cruciate ligament under axial tension is not clear. OBJECTIVE:To quantitatively analyze the effect of elastin on the tensile mechanical response of the anterior cruciate ligament. METHODS:Elastase solution and control buffer were prepared.The porcine anterior cruciate ligament samples were prepared into small-size samples and randomly soaked in 0,0.1,1.0,2.0,5.0,and 10.0 U/mL elastase solution for 6 hours,and other small samples of the same size were soaked in 2 U/mL elastase solution for 0,1,3,6,9,and 12 hours.To determine suitable soaking conditions for elastin-targeted enzymes and verify the digestive effect,histological staining was used to compare the effects of enzyme treatment on tissue structure and composition.The ligament samples were randomly divided into elastase-treated group and PBS group,and immersed in 2 U/mL elastase solution and PBS buffer for 6 hours,respectively.A mechanical tensile test was performed before and after immersion. RESULTS AND CONCLUSION:(1)The biochemical results showed that being treated in 2 U/mL elastase solution for 6 hours could reduce the elastin content by 31.1%,and had no significant effect on other mechanical-related components in the tissue.(2)The histological results showed that elastase was able to penetrate the tissue,and the loose degree of tissue increased after treatment.(3)In the mechanical results before and after treatment,the mechanical properties of the PBS group decreased significantly,only the low-tension elastic modulus increased significantly and the initial length increased significantly in the elastase-treated group.(4)The intergroup comparison results showed that there was no significant difference between the two groups in pre-treatment,but the low-tension elastic modulus,initial slopes,saturated slopes,and initial length of the elastase-treated group after treatment were significantly higher than those in the PBS group.(5)These results suggest that elastin degradation significantly affects the biomechanical properties of the anterior cruciate ligament and further complements our understanding of the structure-function relationship of the anterior cruciate ligament.

Portal vein tumor thrombus (PVTT) is one of the common complications of hepatocellular carcinoma (HCC) with a high mortality rate. Several studies have shown that active implementation of effective treatment can significantly improve the quality of life and prolong survival of HCC patients with PVTT. In recent years, with the continuous development of molecular biology and molecular immunology, the treatment of advanced liver cancer has shifted from single agent to combination therapy, among which, the combination of immune checkpoint inhibitors and other systemic or local therapies has attracted much attention. This treatment strategy has shown good efficacy in some large-scale clinical trials. With the deepening of relevant research, it is believed that this treatment scheme will bring more hope and opportunities to such patients.

Background and purpose:Long noncoding RNA(lncRNA)can regulate gene transcription,mRNA shear,stabilization and translation,and it is an important regulatory factor in a variety of biological processes.This study aimed to investigate the expression and clinical features of lncRNA FLJ30679 in oral squamous cell carcinoma(OSCC)and its effect on the malignant biological behavior of OSCC.Methods:The expression of FLJ30679 in head and neck squamous cell carcinoma(HNSCC)tissues and normal tissues was analyzed by the UCSC Xena database for expression and prognosis.The expression of FLJ30679 in OSCC cell lines was detected by real-time fluorescence quantitative polymerase chain reaction(RTFQ-PCR).The subcellular localization of FLJ30679 in OSCC cells was detected by RNA nuclear-cytoplasmic fractionation assays.FLJ30679 Smart Silencer was used to establish the FLJ30679 knockdown group(SS-FLJ30679),and overexpression plasmid of FLJ30679 was used to establish FLJ30679 overexpression group(FLJ30679).The effects of altered FLJ30679 expression on the proliferative and migration capacity of OSCC cells were examined by cell counting kit-8(CCK-8)and transwell migration assays.RTFQ-PCR and Western blot were used to determine the effect of altered FLJ30679 expression on the expression of epithelial-mesenchymal transition(EMT)-related genes in OSCC cells.The effects of altered FLJ30679 expression on the phosphoinositide 3-kinase(PI3K)/protein kinase(AKT)pathway were detected by Western blot.Results:Online query of database showed that FLJ30679 expression was higher in HNSCC tissues compared to normal tissues(P＜0.01).HNSCC patients with higher FLJ30679 expression had lower overall survival(P＜0.01).The RTFQ-PCR results showed that FLJ30679 was expressed at a higher level in six OSCC cell lines compared with normal cells,and was predominantly localized in the nucleus.The ability of OSCC cells in the SS-FLJ30679 group to proliferate and migrate was significantly lower compared with the SS-NC group(P＜0.01).OSCC cells in the FLJ30679 overexpression group had significantly higher proliferative and migratory capacities than those in the vector group(P＜0.001).RTFQ-PCR and Western blot results showed that FLJ30679 knockdown resulted in upregulation of mRNA and protein expression levels of E-cadherin(P＜0.01)and downregulation of mRNA and protein expression levels of N-cadherin and vimentin(P＜0.01).FLJ30679 overexpression resulted in downregulation of protein expression levels of E-cadherin(P＜0.01)and upregulation of mRNA and protein expression levels of N-cadherin and vimentin(P＜0.05).Western blot results showed that knockdown of FLJ30679 resulted in decreased protein expression levels of phosphorylated-PI3K(p-PI3K)and phosphorylated-AKT(p-AKT)(P＜0.001),and overexpression of FLJ30679 resulted in increased protein expression levels of p-PI3K and p-AKT(P＜0.01).Conclusion:The expression of FLJ30679 was increased in OSCC tissues and cells.It promoted the proliferation and migration ability of OSCC cells,which may be caused by FLJ30679 promoting EMT via PI3K/AKT pathway.

Objective:To investigated the expression and localization of the long non-coding RNA(lncRNA)STAG3L5P in oral squamous cell carcinoma(OSCC)cells and its effects on OSCC cell proliferation and migration.Methods:STAG3L5P expression in HNSC and OSCC was ana-lyzed online using gene expression profiling interactive analysis 2(GEPIA2)and the University of California Santa Cruz Xena(UCSC Xena)database,respectively.STAG3L5P expression in OSCC cell lines was detected using real-time fluorescence quantitative PCR(qPCR).Nuclear-cytoplasmic RNA fractionation assays were carried out to pinpoint the location of STAG3L5P.Cell counting kit-8(CCK-8)and Transwell migra-tion assays were used to assess OSCC cell proliferation and migration changes.The effect of STAG3L5P overexpression on epithelial-mesen-chymal transition(EMT)related gene expression was detected by qPCR and Western blot.The effect of STAG3L5P overexpression on PI3K/AKT pathway activity was also assessed by Western blot.Results:STAG3L5P was highly expressed in OSCC,and its expression correl-ated significantly with histological grade.STAG3L5P expression was significantly higher in OSCC cell lines than in normal cells.The level of cytoplasmic STAG3L5P in OSCC cells was significantly higher than that in the nucleus.The proliferation and migration capacity of OSCC cells overexpressing STAG3L5P were significantly enhanced compared to negative control OSCC cells.N-cadherin and vimentin mRNA and protein levels were significantly increased by STAG3L5P overexpression,while E-cadherin protein expression was decreased.Overexpression of STAG3L5P also increased activity of p-PI3K and p-AKT.Conclusions:STAG3L5P is up-regulated in OSCC,and STAG3L5P overexpression can promote OSCC cell proliferation and migration.This effect may be related to activation of the PI3K/AKT pathway,thus promoting EMT.

Objective:To compare the reliability between infrared thermal imaging technology(IRT) and colour Doppler ultrasound (CDU) in the detection of perforators for anterolateral femoral perforator flap(ALTPF).Methods:From September, 2017 to September, 2019, a total of 25 patients(16 males and 9 females, aged 12-53 years old with an average age of 38.7 years old) underwent ALTPF surgery for the purpose of resurfacing and reconstruction. All patients had pedicled or free ALTPF sized from 5.0 cm×8.0 cm to 7.5 cm×30.0 cm. Among all cases, 21 received free flaps and 4 received pedicled flaps. All patients underwent routine IRT and CDU examinations to locate the perforators preoperatively.Results:Of the 25 patients, CDU detected 53 perforators and IRT detected 51 "hot spots". There were 50 "hot spots" that corresponded to the findings of CDU with a κ index at 0.712( P<0.05), representing a high degree of consistency. The sensitivity and specificity were 94.3% and 85.7%, respectively. Conclusion:IRT has a high consistency in detecting perforators for ALTPF in comparison with CDU. IRT features portable, low cost, non-invasive, and easy to operate. At the same time, IRT has advantages in the patients who have thin subcutaneous tissue. With higher accuracy, IRT is expected to become an important part of preoperative perforator navigation.

The location of perforator vessel and blood supply of the flap are the most concerned issues in flap surgery. Recently, infrared thermography (IRT) has been gradually applied in flap surgery as a portable, non-invasive, rapid and economical measure. It detects the infrared radiation emitted by the human body and accurately describes the thermal distribution on the surface of tissues. This review summarizes the application of infrared thermography in different aspects including perforator detection and perfusion monitoring. This review also summarizes the potential value of the use of infrared thermography to provide references and assistance for clinicians in improvement of surgical outcomes in the flap surgery.

Objective:To explore ways and methods for public mental health intervention during the COVID-19 epidemic.Methods:A comprehensive literature review was conducted. Mental healthcare publicity materials posted by over 100 Chinese hospitals in multiple media (till February 24, 2020) were also systematically collected and analyzed.Results:Firstly, anxiety and fear were the most common mental health problems among people during the epidemic. Secondly, to achieve better outcomes, mental health intervention should be provided according to the type of service clients. Thirdly, new media can facilitate the transmission of mental healthcare knowledge, but the limitation is that it can not approach older adults who have limited access to new media. It is therefore essential to strengthen the mental health knowledge transmission to older adults.Conclusions:Mental health intervention is effective when it is provided according to the type of service clients during the COVID-19 epidemic.

Objective To investigate the relationship between aberrant expression of interleukin 6 (IL-6) and gene methylation in patients with ulcerative colitis (UC),and to clarify the mechanism of epigenetics in UC.Methods From March 2017 to March 2018,a total of 59 UC patients admitted to the Department of Gastroenterology,General Hospital Affiliated to Tianjin Medical University were enrolled,and at the same time 58 normal individuals who received health checkups were selected as healthy controls.Blood samples and colonic mucosa specimens of UC group and healthy control group were collected.DNA methyltransferase (DNMT) activity,methylation level of CpG locus in IL-6 promoter region and expression level of IL-6 were detected.Chi-square test and student's t test were performed for statistical analysis.Results The methylation level and IL-6 expression level examination were completed in 24 and 30 cases of UC group,respectively;which were detected in 21 and 20 cases of healthy control group,respectively.The activity of DNMT of UC group was significantly lower than that of healthy control group ((16.48 ± 6.17) OD · h-1 · mg-1 vs.(62.48 ± 33.88) OD · h-1 ·mg-1),and the difference was statistically significant (t =3.707,P ＜ 0.05).The ratios of methylation,partial methylation and non-methylation of UC group were 31.2％ (15/48),50.0％ (24/48) and 18.8％ (9/48),respectively,and those of healthy control group were 58.3％ (35/60),21.7％ (13/60) and 20.0％ (12/60),and the difference between the two groups was statistically significant (x2 =10.495,P ＜ 0.05).The positive expression rate of IL-6 in intestinal mucosa of UC group was higher than that of healthy control group (100.0％,21/21 vs.25.0％,5/20),and the difference was statistically significant (x2 =24.837,P ＜0.05).The serum IL-6 level of UC group was higher than that of healthy control group ((1 075.02 ±661.95) ng/L vs.(583.43 ± 425.10) ng/L),and the difference was statistically significant (t =3.245,P ＜ 0.05).Conclusion The decrease of DNMT activity in the intestinal mucosa of UC patients may reduce the methylation level of IL-6 gene promoter region,which is correlated with the increased level of IL-6 expression in the intestinal mucosa and serum,and involve in the inflammatory process of UC.

Objective To explore the application value of retrobulbar nerve block combined with general anesthesia in the penetrating keratoplasty (PKP). Methods A total of 100 recipients undergoing PKP from January 2017 to January 2019 were recruited in this study. All recipients were divided into the observation group (n=50) and control group (n=50) by random number table method. In the control group, patients received laryngeal mask airway under general anesthesia, and in the observation group, patients received laryngeal mask airway under general anesthesia combined with retrobulbar nerve block. Hemodynamic changes of the PKP recipients before and after operation were observed in two groups. The dosage of analgesic drugs and the incidence of complications were observed in two groups. The degree of pain at postoperative 2-, 6- and 24-h was evaluated by visual analogue scale (VAS) in two groups. The awakening situation of the recipients in two groups was observed. The levels of inflammatory cytokines at 1 d before and after operation were statistically compared in two groups. Results The average arterial pressure and heart rate at intraoperative 15 min and after the surgery in the observation group were significantly higher than those in the control group (both P < 0.05). In the observation group, the dosage of remifentanil and propofol were (1.0±0.4) mg and (299±40) mg, significantly lower than (1.3±0.6) mg and (365±42) mg in the control group (both P < 0.05). The incidence of complications did not significantly differ between two groups (P > 0.05). In the observation group, the VAS scores at 2-, 6- and 12-h after operation were remarkably lower than those in the control group (all P < 0.01). The respiratory recovery time, eye opening time, directional force recovery time and extubation time of the recipients in the observation group were significantly shorter than those in the control group (all P < 0.05). The expression levels of including interleukin (IL)-1, IL-6 and tumor necrosis factor-α (TNF-α) at postoperative 1 d in the observation group were considerably lower than those in the control group (all P < 0.05). Conclusions Retrobulbar nerve block combined with general anesthesia can maintain hemodynamic stability during PKP, reduce the dosage of remifentanil and propofol and alleviate the degree of postoperative pain and inflammatory responses of the recipients.