Objective:To investigate the expression of EIF3B and its role in the development of laryngeal carcinoma. Methods:Immunohistochemistry, cell culture, cell transfection, qRT-PCR, Western Blot and other techniques were used to determine the expression difference of EIF3B in laryngeal cancer and adjacent tissues, and analyze the relationship between EIF3B and the size and TNM stage of laryngeal cancer. By constructing a laryngeal carcinoma cell model with EIF3B knocked down, the cell function was studied, and the regulatory effect of EIF3B on laryngeal carcinoma cells was proved in vitro. Finally, the effect of EIF3B on laryngeal carcinoma growth in vivo was studied by subcutaneous xenograft tumor model in nude mice. Results:The signal intensity of EIF3B in laryngeal carcinoma tissues was significantly stronger than that in adjacent tissues, and the expression level of EIF3B was positively correlated with patient age, TNM stage, lymph node metastasis, tumor size and clinical stage. Knocking down EIF3B can significantly inhibit the proliferation, migration and aggregation of cancer cells, and promote apoptosis. In vivo experiments with nude mice also showed that down-regulating EIF3B expression could inhibit tumor formation in vivo. Conclusion:The expression of EIF3B in laryngeal cancer is significantly increased, and it is closely related to the pathological characteristics of laryngeal cancer, which can be used as a diagnostic index of laryngeal cancer. In terms of function, EIF3B knockdown can inhibit the proliferation, migration and tumor formation of laryngeal cancer cells in vitro and in vivo, and may become a candidate target for targeted therapy of laryngeal cancer in the future.
Laryngeal Neoplasms/pathology* ; Humans ; Eukaryotic Initiation Factor-3/metabolism* ; Animals ; Mice, Nude ; Mice ; Cell Line, Tumor ; Cell Proliferation ; Apoptosis ; Cell Movement ; Neoplasm Staging ; Male ; Transfection ; Female ; Middle Aged ; Gene Expression Regulation, Neoplastic

Objective:To compare the efficacy of two surgical approaches for lumbar Brucellar spondylitis: one-stage posterior approach debridement with intervertebral bone graft fusion and pedicle screw-rod internal fixation (simple posterior group) versus one-stage anterior approach debridement with intervertebral bone graft fusion combined with posterior pedicle screw-rod internal fixation (combined anterior-posterior group).Methods:A systematic search was performed in the Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP, and Wanfang Data from the time of database establishment to May 2024 to identify randomized controlled trial (RCT) and controlled clinical trial (CCT) comparing the two surgical approaches (simple posterior group and combined anterior-posterior group) in the treatment of lumbar Brucellar spondylitis. Meta-analysis was conducted by two researchers using RevMan 5.4.0 and Stata 13.1 software.Results:A total of 8 studies (2 RCTs, 6 CCTs studies) were included, including 669 patients (344 in the simple posterior group and 325 in the combined anterior-posterior group). Meta-analysis results revealed that the simple posterior group demonstrated shorter surgical time [ WMD = - 125.68, 95% CI ( - 186.84, - 64.53), P < 0.001], less intraoperative bleeding [ WMD = - 385.76, 95% CI ( - 572.40, - 199.11), P < 0.001], shorter hospital stay [ WMD = - 5.60, 95% CI ( - 8.30, - 2.91), P < 0.001], earlier postoperative ambulation time [ WMD = - 6.15, 95% CI ( - 10.72, - 1.59), P = 0.008], and a smaller Cobb angle at 3 months after surgery [ WMD = - 0.66, 95% CI ( - 1.23, - 0.09), P = 0.020]. However, there was no statistically significant differences in erythrocyte sedimentation rate [ WMD = 0.01, 95% CI ( - 0.90, 0.93), P = 0.980], visual analogue scale scores [ WMD = - 0.19, 95% CI ( - 0.40, 0.01), P = 0.070], Oswestry disability index score [ WMD = 0.02, 95% CI ( - 0.61, 0.66), P = 0.950] at 3 months after surgery, and postoperative complication rate [ OR = 0.57, 95% CI (0.17, 1.94), P = 0.370]. Conclusions:Compared with the combined anterior-posterior approach, the simple posterior approach has the advantages of shorter surgical time, less bleeding, and faster postoperative recovery. However, there is no significant difference between the two in terms of symptom improvement, functional recovery, and incidence of complications. Simple posterior approach surgery is an effective choice for treating lumbar Brucellar spondylitis.

Objective:To compare the efficacy of two surgical approaches for lumbar Brucellar spondylitis: one-stage posterior approach debridement with intervertebral bone graft fusion and pedicle screw-rod internal fixation (simple posterior group) versus one-stage anterior approach debridement with intervertebral bone graft fusion combined with posterior pedicle screw-rod internal fixation (combined anterior-posterior group).Methods:A systematic search was performed in the Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP, and Wanfang Data from the time of database establishment to May 2024 to identify randomized controlled trial (RCT) and controlled clinical trial (CCT) comparing the two surgical approaches (simple posterior group and combined anterior-posterior group) in the treatment of lumbar Brucellar spondylitis. Meta-analysis was conducted by two researchers using RevMan 5.4.0 and Stata 13.1 software.Results:A total of 8 studies (2 RCTs, 6 CCTs studies) were included, including 669 patients (344 in the simple posterior group and 325 in the combined anterior-posterior group). Meta-analysis results revealed that the simple posterior group demonstrated shorter surgical time [ WMD = - 125.68, 95% CI ( - 186.84, - 64.53), P < 0.001], less intraoperative bleeding [ WMD = - 385.76, 95% CI ( - 572.40, - 199.11), P < 0.001], shorter hospital stay [ WMD = - 5.60, 95% CI ( - 8.30, - 2.91), P < 0.001], earlier postoperative ambulation time [ WMD = - 6.15, 95% CI ( - 10.72, - 1.59), P = 0.008], and a smaller Cobb angle at 3 months after surgery [ WMD = - 0.66, 95% CI ( - 1.23, - 0.09), P = 0.020]. However, there was no statistically significant differences in erythrocyte sedimentation rate [ WMD = 0.01, 95% CI ( - 0.90, 0.93), P = 0.980], visual analogue scale scores [ WMD = - 0.19, 95% CI ( - 0.40, 0.01), P = 0.070], Oswestry disability index score [ WMD = 0.02, 95% CI ( - 0.61, 0.66), P = 0.950] at 3 months after surgery, and postoperative complication rate [ OR = 0.57, 95% CI (0.17, 1.94), P = 0.370]. Conclusions:Compared with the combined anterior-posterior approach, the simple posterior approach has the advantages of shorter surgical time, less bleeding, and faster postoperative recovery. However, there is no significant difference between the two in terms of symptom improvement, functional recovery, and incidence of complications. Simple posterior approach surgery is an effective choice for treating lumbar Brucellar spondylitis.

Objective:To explore the anatomical parameters of the ideal trajectory for pedicle screw fixation through the lamina in the treatment of L 5 spondylolysis. Methods:CT data from 40 male patients with bilateral L 5 spondylolysis (age, 24.95±4.01 years; range, 20-36 years), treated at the 940th Hospital of PLA Joint Logistics Support Force between January 2021 and June 2024, were analyzed. Three-dimensional vertebral models were reconstructed using this data. Measurements included the lumbosacral angle, the thickness at the midpoint of the superior and inferior lamina edges, mid-lamina thickness, the distance from the lateral edge of the lamina to the spinous process midline, the thickness at the defect of the pars interarticularis, and the vertical diameter of the defect. The screws were inserted from the inferior edge of the lamina, passing through the pars interarticularis defect, and exiting at the superior edge of the pedicle. In the vertical direction of the lamina, the inferior and superior edges of the lamina were divided into three zones, named A, B, C (for the inferior lamina edge) and 1, 2, 3 (for the superior pedicle edge). Seven trajectories (A2, A3, B1, B2, B3, C2, and C3) were designed by combining these zones. Screws with diameters of 5.0, 4.5, 4.0, and 3.5 mm were sequentially inserted along each trajectory. Screw trajectories with an insertion success rate ≥95% were selected and evaluated for feasibility. Parameters such as screw length, medial inclination angle, caudal inclination angle, and entry point position were measured. The ideal trajectory and screw dimensions were determined by considering anatomical features, screw characteristics, and insertion safety. Results:The measurement results from the 3D model showed that the lumbosacral angle was 36.22°±5.23°, and the midpoint thickness of the superior lamina edge was 4.14±0.66 mm (left) and 4.18±0.65 mm (right), the mid-lamina thickness was 6.73±0.72 mm (left) and 6.72±0.70 mm (right), the midpoint thickness of the inferior lamina edge was 6.50±0.56 mm (left) and 6.50±0.66 mm (right), the distance from the lateral edge of the lamina to the spinous process midline was 25.95±2.86 mm (left) and 26.39±3.10 mm (right), the thickness at the pars defect was 9.67±0.57 mm (left) and 9.67±0.51 mm (right), and the vertical diameter of the pars defect was 18.76±2.16 mm (left) and 19.26±2.03 mm (right). No statistically significant differences were found between the left and right sides for these parameters ( P>0.05). The trajectories considered feasible and with an insertion success rate ≥95% were B2, B3, C2, and C3. Safe screw diameters were B2 (4.5 mm), B3 (4.0 mm), C2 (4.0 mm), and C3 (3.5 mm). Corresponding screw lengths were B2 (38.28±2.34 mm), B3 (37.03±2.99 mm), C2 (38.37±2.42 mm), and C3 (36.88±2.87 mm). The caudal inclination angles were B2 (52.73°±5.29°), B3 (55.06°± 4.46°), C2 (49.09°±3.92°), and C3 (50.18°±4.36°). The medial inclination angles were B2 (21.21°±3.01°), B3 (5.11°±1.58°), C2 (22.55°±2.46°), and C3 (12.59°±1.80°). The distances from the entry point to the spinous process midline were B2 (13.23±1.68 mm), B3 (13.15±1.46 mm), C2 (11.12±0.64 mm), and C3 (11.09±0.65 mm). The distances from the entry point to the root of the spinous process were B2 (8.23±1.46 mm), B3 (8.21±1.31 mm), C2 (6.65 ±0.76 mm), and C3 (6.67±0.72 mm). Differences in screw length, caudal inclination angle, medial inclination angle, and entry point position across trajectories were statistically significant ( P<0.05). Conclusion:The ideal screw trajectory for L 5 spondylolysis involves insertion through the midpoint of the entry zone, passing through the pars defect, and exiting at the midpoint of the superior edge of the pedicle. The optimal entry point is located on the inferior edge of the lamina, 8.23±1.46 mm from the root of the spinous process and 13.23±1.68 mm from the spinous process midline. The screw should be placed at a caudal inclination angle of 52.73°±5.29° and a medial inclination angle of 21.21°±3.01°. The recommended screw length is 38.28±2.34 mm, with a diameter of 4.5 mm (range, 4.5-5.0 mm).

Objective:To explore the anatomical parameters of the ideal trajectory for pedicle screw fixation through the lamina in the treatment of L 5 spondylolysis. Methods:CT data from 40 male patients with bilateral L 5 spondylolysis (age, 24.95±4.01 years; range, 20-36 years), treated at the 940th Hospital of PLA Joint Logistics Support Force between January 2021 and June 2024, were analyzed. Three-dimensional vertebral models were reconstructed using this data. Measurements included the lumbosacral angle, the thickness at the midpoint of the superior and inferior lamina edges, mid-lamina thickness, the distance from the lateral edge of the lamina to the spinous process midline, the thickness at the defect of the pars interarticularis, and the vertical diameter of the defect. The screws were inserted from the inferior edge of the lamina, passing through the pars interarticularis defect, and exiting at the superior edge of the pedicle. In the vertical direction of the lamina, the inferior and superior edges of the lamina were divided into three zones, named A, B, C (for the inferior lamina edge) and 1, 2, 3 (for the superior pedicle edge). Seven trajectories (A2, A3, B1, B2, B3, C2, and C3) were designed by combining these zones. Screws with diameters of 5.0, 4.5, 4.0, and 3.5 mm were sequentially inserted along each trajectory. Screw trajectories with an insertion success rate ≥95% were selected and evaluated for feasibility. Parameters such as screw length, medial inclination angle, caudal inclination angle, and entry point position were measured. The ideal trajectory and screw dimensions were determined by considering anatomical features, screw characteristics, and insertion safety. Results:The measurement results from the 3D model showed that the lumbosacral angle was 36.22°±5.23°, and the midpoint thickness of the superior lamina edge was 4.14±0.66 mm (left) and 4.18±0.65 mm (right), the mid-lamina thickness was 6.73±0.72 mm (left) and 6.72±0.70 mm (right), the midpoint thickness of the inferior lamina edge was 6.50±0.56 mm (left) and 6.50±0.66 mm (right), the distance from the lateral edge of the lamina to the spinous process midline was 25.95±2.86 mm (left) and 26.39±3.10 mm (right), the thickness at the pars defect was 9.67±0.57 mm (left) and 9.67±0.51 mm (right), and the vertical diameter of the pars defect was 18.76±2.16 mm (left) and 19.26±2.03 mm (right). No statistically significant differences were found between the left and right sides for these parameters ( P>0.05). The trajectories considered feasible and with an insertion success rate ≥95% were B2, B3, C2, and C3. Safe screw diameters were B2 (4.5 mm), B3 (4.0 mm), C2 (4.0 mm), and C3 (3.5 mm). Corresponding screw lengths were B2 (38.28±2.34 mm), B3 (37.03±2.99 mm), C2 (38.37±2.42 mm), and C3 (36.88±2.87 mm). The caudal inclination angles were B2 (52.73°±5.29°), B3 (55.06°± 4.46°), C2 (49.09°±3.92°), and C3 (50.18°±4.36°). The medial inclination angles were B2 (21.21°±3.01°), B3 (5.11°±1.58°), C2 (22.55°±2.46°), and C3 (12.59°±1.80°). The distances from the entry point to the spinous process midline were B2 (13.23±1.68 mm), B3 (13.15±1.46 mm), C2 (11.12±0.64 mm), and C3 (11.09±0.65 mm). The distances from the entry point to the root of the spinous process were B2 (8.23±1.46 mm), B3 (8.21±1.31 mm), C2 (6.65 ±0.76 mm), and C3 (6.67±0.72 mm). Differences in screw length, caudal inclination angle, medial inclination angle, and entry point position across trajectories were statistically significant ( P<0.05). Conclusion:The ideal screw trajectory for L 5 spondylolysis involves insertion through the midpoint of the entry zone, passing through the pars defect, and exiting at the midpoint of the superior edge of the pedicle. The optimal entry point is located on the inferior edge of the lamina, 8.23±1.46 mm from the root of the spinous process and 13.23±1.68 mm from the spinous process midline. The screw should be placed at a caudal inclination angle of 52.73°±5.29° and a medial inclination angle of 21.21°±3.01°. The recommended screw length is 38.28±2.34 mm, with a diameter of 4.5 mm (range, 4.5-5.0 mm).

Objective: To investigate the expression of syndecan-1 and syndecan-2 and their clinicopathological significance in patients with gallbladder squamous cell (SC)/adenosquamous carcinoma (ASC) and adenocarcinoma (AC). Methods: A total of 126 patients with SC/ASC (n=46) and AC (n=80) were included in this study. The expression levels of syndecan-1 and syndecan-2 were detected by Envison™ immunohistochemistry assay. The clinical and prognostic significance of syndecan-1 and syndecan-2 were analyzed. Results: In the 46 SC/ASC samples, syndecan-1 and syndecan-2 were positively expressed in 29 (63.0%) and 28 (60.9%) tumor tissues, respectively. (Positive expression was defined based on the staining in the component of squamous cell carcinoma. That is to say, the tissue which adenocarcinoma part was positively stained, but squamous cell carcinoma part was negatively stained is also regarded as negative.) In the 80 AC samples, 47 (58.8%) cases showed syndecan-1 positive expression, and 51 (63.8%) showed syndecan-2 positive expression. There was no significant difference in the positive rates of syndecan-1 and syndecan-2 between SC/ASC and AC groups (P>0.05 for all). The levels of syndecan-1 and syndecan-2 were associated with tumor size, TNM staging, lymph node metastasis, invasion of adjacent tissue, and surgical procedures in SC/ASC patients (P<0.05 for all). However, their expression was associated with tumor differentiation, tumor size, TNM staging, lymph node metastasis, invasion of adjacent tissue, and surgical procedures in AC patients (P<0.05 for all). The Kaplan-Meier survival analysis of SC/ASC and AC patients revealed that the average survival time for patients with positive syndecan-1 and syndecan-2 expression was significantly shorter than that of those with negative expression (P<0.01 for all). Cox multivariate analysis indicated that syndecan-1 and syndecan-2 expression were independent unfavorable prognostic factors for SC/ASC and AC patients (P<0.05 for all). Conclusion The syndecan-1 and syndecan-2 expression are associated with the tumor progression and poor prognosis in patients with gallbladder SC/ASC and AC.

Objective To investigate the expression of syndecan?1 and syndecan?2 and their clinicopathological significance in patients with gallbladder squamous cell ( SC)/adenosquamous carcinoma ( ASC) and adenocarcinoma ( AC) . Methods A total of 126 patients with SC/ASC ( n=46) and AC ( n=80) were included in this study. The expression levels of syndecan?1 and syndecan?2 were detected by EnvisonTM immunohistochemistry assay. The clinical and prognostic significance of syndecan?1 and syndecan?2 were analyzed. Results In the 46 SC/ASC samples, syndecan?1 and syndecan?2 were positively expressed in 29 (63.0％) and 28 (60.9％) tumor tissues, respectively. (Positive expression was defined based on the staining in the component of squamous cell carcinoma. That is to say, the tissue which adenocarcinoma part was positively stained, but squamous cell carcinoma part was negatively stained is also regarded as negative.) In the 80 AC samples, 47 (58.8％) cases showed syndecan?1 positive expression, and 51 (63.8％) showed syndecan?2 positive expression. There was no significant difference in the positive rates of syndecan?1 and syndecan?2 between SC/ASC and AC groups ( P>0. 05 for all ) . The levels of syndecan?1 and syndecan?2 were associated with tumor size, TNM staging, lymph node metastasis, invasion of adjacent tissue, and surgical procedures in SC/ASC patients ( P<0. 05 for all ) . However, their expression was associated with tumor differentiation, tumor size, TNM staging, lymph node metastasis, invasion of adjacent tissue, and surgical procedures in AC patients ( P<0.05 for all) . The Kaplan?Meier survival analysis of SC/ASC and AC patients revealed that the average survival time for patients with positive syndecan?1 and syndecan?2 expression was significantly shorter than that of those with negative expression ( P<0.01 for all) . Cox multivariate analysis indicated that syndecan?1 and syndecan?2 expression were independent unfavorable prognostic factors for SC/ASC and AC patients ( P<0. 05 for all ) . Conclusion The syndecan?1 and syndecan?2 expression are associated with the tumor progression and poor prognosis in patients with gallbladder SC/ASC and AC.

Objective To investigate the expression of syndecan?1 and syndecan?2 and their clinicopathological significance in patients with gallbladder squamous cell ( SC)/adenosquamous carcinoma ( ASC) and adenocarcinoma ( AC) . Methods A total of 126 patients with SC/ASC ( n=46) and AC ( n=80) were included in this study. The expression levels of syndecan?1 and syndecan?2 were detected by EnvisonTM immunohistochemistry assay. The clinical and prognostic significance of syndecan?1 and syndecan?2 were analyzed. Results In the 46 SC/ASC samples, syndecan?1 and syndecan?2 were positively expressed in 29 (63.0％) and 28 (60.9％) tumor tissues, respectively. (Positive expression was defined based on the staining in the component of squamous cell carcinoma. That is to say, the tissue which adenocarcinoma part was positively stained, but squamous cell carcinoma part was negatively stained is also regarded as negative.) In the 80 AC samples, 47 (58.8％) cases showed syndecan?1 positive expression, and 51 (63.8％) showed syndecan?2 positive expression. There was no significant difference in the positive rates of syndecan?1 and syndecan?2 between SC/ASC and AC groups ( P>0. 05 for all ) . The levels of syndecan?1 and syndecan?2 were associated with tumor size, TNM staging, lymph node metastasis, invasion of adjacent tissue, and surgical procedures in SC/ASC patients ( P<0. 05 for all ) . However, their expression was associated with tumor differentiation, tumor size, TNM staging, lymph node metastasis, invasion of adjacent tissue, and surgical procedures in AC patients ( P<0.05 for all) . The Kaplan?Meier survival analysis of SC/ASC and AC patients revealed that the average survival time for patients with positive syndecan?1 and syndecan?2 expression was significantly shorter than that of those with negative expression ( P<0.01 for all) . Cox multivariate analysis indicated that syndecan?1 and syndecan?2 expression were independent unfavorable prognostic factors for SC/ASC and AC patients ( P<0. 05 for all ) . Conclusion The syndecan?1 and syndecan?2 expression are associated with the tumor progression and poor prognosis in patients with gallbladder SC/ASC and AC.

Objective To assess the cardiopulmonary exercise testing (CPET) derived performance of oxygen uptake and ventilation efficiency parameters,including oxygen uptake efficiency plateau (OUEP),oxygen uptake efficiency slope (OUES),(V)E/(V)CO2 slope and lowest (V)E/(V)CO2,in patients with end-stage chronic heart failure(CHF) and evaluate their clinical value on monitoring cardiac function and hemodynamic status.Methods A total of 26 end-stage CHF patients considered for heart transplantation were enrolled in this study.CPET,echocardiography and invasive hemodynamic examinations with Swan-Ganz flowing balloon catheter were performed.Correlation analysis was made between oxygen uptake and ventilation efficiency parameters from CPET and echocardiographic and hemodynamic parameters.Results OUEP and OUES showed good correlation with peak oxygen consumption (peak (V)O2) (r =0.535,P ＜ 0.01 ; r =0.840,P ＜ 0.001).In end-stage CHF patients,the slope of OUEP with respect to peak (V)O2 is about 32,but the slope of OUES with respect to peak (V)O2 is only about 2.The difference was 16 times.The change of OUEP was more sensitive and significant than those of OUES and peak (V)O2 (P ＜ 0.05).OUEP,peak (V)O2 (％ pred),(V)E/(V)CO2 slope and lowest (V)E/(V)CO2 were all correlated well with non-invasive hemodynamic parameters peak cardiac output (r=0.535,P＜0.01; r=0.652,P＜0.001; r=-0.640,P＜0.001 ; r=-0.606,P=0.001 respectively) and peak cardiac index (r =0.556,P＜0.01;r =0.772,P ＜0.001; r =-0.641,P ＜ 0.001 ; r =-0.620,P ＜ 0.001 respectively) derived from CPET,but not correlated with invasive hemodynamic parameters cardiac output and cardiac index at rest (P ＞0.05).Both peak (V)O2 (％ pred) and (V)E/(V)CO2 slope were significantly correlated with invasive hemodynamic parameters systolic pulmonary arterial pressure (r =-0.424,P ＜ 0.05 ; r =0.509,P ＜ 0.01) and mean pulmonary arterial pressure (r=-0.479,P＜0.05; r=0.405,P＜0.05).Peak (V)O2(％pred)was also significantly correlated with pulmonary capillary wedge pressure (r =-0.415,P ＜ 0.05),and (V)E/(V)CO2 slope was significantly correlated with pulmonary vascular resistance (r =0.429,P ＜ 0.05).Conclusions The oxygen uptake and ventilation efficiency parameters derived from CPET,including peak (V)O2,OUEP,lowest (V)E/(V)CO2 and (V)E/(V)CO2 slope etc,are objectively monitoring and evaluating cardiac function and hemodynamic status.And they are useful for optimizing clinical management of patients with end-stage CHF.

Objective To observe oxygen uptake efficiency plateau (OUEP,i.e.highest (V)O2/(V)E) and carbon dioxide output efficiency (lowest (V)E/(V)CO2) parameter changes during exercise in normal subjects.Methods Five healthy volunteers performed the symptom limited maximal cardiopulmonary exercise test (CPET) at Harbor-UCLA Medical Center.(V)O2/(V) E and (V) E/(V) CO2 were determined by both arterial and central venous catheters.After blood gas analysis of arterial and venous sampling at the last 30 seconds of every exercise stage and every minute of incremental loading,the continuous parameter changes of hemodynamics,pulmonary ventilation were monitored and oxygen uptake ventilatory efficiency ((V)O2/(V)E and (V) E/(V)CO2) was calculated.Results During CPET,as the loading gradually increased,cardiac output,heart rate,mixed venous oxygen saturation,arteriovenous oxygen difference,minute ventilation,minute alveolar ventilation,tidal volume,alveolar ventilation and pulmonary ventilation perfusion ratio increased near-linearly (P ＜0.05-0.01,vs.resting); arterial oxygen concentration maintained at a high level without significant change (P ＞ 0.05) ; stroke volume,respiratory rate,arterial partial pressure of carbon dioxide,arterial blood hydrogen ion concentration and dead space ventilation ratio significantly changed none-linearly (compare resting state P ＜ 0.05-0.01).OUE during exercise increased from 30.9 ± 3.3 at resting state to the highest plateau 46.0 ± 4.7 (P ＜ 0.05 vs.resting state),then,declined gradually after anaerobic threshold (P ＜ 0.05 -0.01,vs.OUEP) and reached 36.6 ±4.4 at peak exercise.The (V)E/(V)CO2 during exercise decreased from the resting state (39.2 ± 6.5) to the minimum value (24.2 ± 2.4) after AT for a few minutes (P ＞ 0.05 vs.earlier stage),then gradually increased after the ventilatory compensation point (P ＜ 0.05 vs.earlier stage) and reached to 25.9 ± 2.7 at peak exercise.Conclusions Cardiac and lung function as well as metabolism change during CPET is synchronous.In the absence of pulmonary limit,appearing before and after anaerobic threshold,OUEP and lowest (V) E/(V) CO2 could be used as reliable parameters representing the circulatory function.