Colorectal cancer is one of the most common malignant tumors, which is a great threat to human life and health. The change of bile acid homeostasis can activate their corresponding receptors to regulate the immune functions, which is closely related to the occurrence of colorectal cancer. In addition, some bile acids can directly induce colorectal cancer and play an important role in the development of colorectal cancer. In this paper, the metabolic process of bile acids in vivo and the immunomodulatory role of bile acid receptors were reviewed, and the evidence of associations between bile acids and colorectal cancer were summarized, which showed the rebalancing the bile acid levels might play a role in the prevention or treatment of colorectal cancer.

Objective:To explore the correlation between the oxygenation index and the monitored parameters of lung injury view in ventilator,so as to provide a basis for monitoring the change of oxygenation index by the parameters of lung injury view.Methods:A total of 28 patients who received mechanical ventilation treatment and admitted to respiratory department of the First Affiliated Hospital with Nanjing Medical University from May 14 to September 30,2024 were selected.The monitored parameters of lung injury views of them during mechanical ventilation treatment with invasive ventilators were collected,including platform pressure(Pplat),driving pressure(ΔP),mechanical energy(Emech),ratio of tidal volume to ideal body weight(TVe/IBW),etc..Then,the data of oxygenation index were obtained.Finally,135 valid data were screened out.The 84 pieces of data with oxygenation index≤300mmHg were included in low oxygen group,and 51 data with oxygenation index>300mmHg were included in normal group.The correlations between oxygenation index and Pplat,ΔP,Emech,TVe/IBW were conducted by pairwise analysis.Results:In the low oxygen group,the oxygenation index was[(196.302±74.522)mmHg]significantly negative correlation with Emech[(12.686±5.401)J/min](ρ=-0.425,P<0.05),but not was significant correlation with Pplat,ΔP,and TVe/IBW(P>0.05).In the normal group,there were not significant correlations between the oxygenation index and Pplat,ΔP,Emech and TVe/IBW(P>0.05).There was a significant negative correlation between Emech and rank of oxygenation index(β=-0.389,P<0.05)in the low oxygen group.Conclusion:The visualization function of the Emech of the monitored parameters in lung injury view of ventilator can provide help for monitoring the changes of oxygenation index of patients in the low oxygen group,and can improve the oxygenation of patients by optimizing mechanical energy.However,it is necessary to balance the contradiction between ventilation intensity and protection for lung.

Objective:To explore more objective detection method for the performance of diagnostic equipment with ultrasound,so as to demonstrate that the subjectivity of the interpretation criteria will affect the results of resolution parameters of detection performance of ultrasonic equipment.Methods:A total of 77 conventional probes of 33 ultrasound equipment of Jiangsu Provincial Hospital were collected and sorted out.The resolution parameters of their performance were tested twice from 2022 to 2023 by the technical personnel of our institute and the tester of Jiangsu Institute of Metrology.The data was described by using the quartiles method.The resolution parameters of performances of ultrasound equipment and probes were paired to conduct Wilcoxon rank sum test,so as to compare the differences in same institute between different years,and in same year between different institute in testing the resolution parameters of performances of ultrasound equipment and probes.Results:For linear array probes,as long as the performance was tested in accordance with the standard method,there was no statistically significant difference in the resolution parameters measured between different institutes and between different times(P>0.05).For the convex array probe,in 2023,the lateral resolution[2(2,2)]of the 70mm target group,and the axial and lateral resolutions[1(1,1)and 3(3,3.25)]of the 120mm target group of our institute were different with the lateral resolution[2(1,2)]of the 70mm target group,and the axial and lateral resolutions[2(2,3)and 2(2,3)]of the 120mm target group of Jiangsu Institute of Metrology,and the differences of them between our institute and Jiangsu Institute of Metrology were significant(Z=-2.887,-2.53,-3.69,P<0.05),respectively.In our institute,the axial and lateral resolutions[1(1,2)and 2.5(2,3)]of the 70mm target group,and the axial resolution[1(1,2)]of the 120mm target group in 2022 were different with the axial and lateral resolutions[1(1,1)and 2(2,2)]of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2023,and the differences of them between two years were significant(Z=-3.317,-3.419,-2.982,P<0.05).In Jiangsu Institute of Metrology,the lateral resolutions of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2022 year were different with those in 2023 year,and the differences of them were significant(Z=-2.333,-3.051,P<0.05),respectively.Conclusion:The interpretation for lateral resolution of convex array probe in target group with high depth,the difference of subjective interpretation criteria will cause the essential difference of final results.This paper suggested that the key image should be retained when the resolution of the image of target group with high depth of the convex array probe is interpreted.At the later stage,artificial intelligence(AI)-assisted quality control can also be introduced to conduct objective interpretation by computers.

Objective:To explore more objective detection method for the performance of diagnostic equipment with ultrasound,so as to demonstrate that the subjectivity of the interpretation criteria will affect the results of resolution parameters of detection performance of ultrasonic equipment.Methods:A total of 77 conventional probes of 33 ultrasound equipment of Jiangsu Provincial Hospital were collected and sorted out.The resolution parameters of their performance were tested twice from 2022 to 2023 by the technical personnel of our institute and the tester of Jiangsu Institute of Metrology.The data was described by using the quartiles method.The resolution parameters of performances of ultrasound equipment and probes were paired to conduct Wilcoxon rank sum test,so as to compare the differences in same institute between different years,and in same year between different institute in testing the resolution parameters of performances of ultrasound equipment and probes.Results:For linear array probes,as long as the performance was tested in accordance with the standard method,there was no statistically significant difference in the resolution parameters measured between different institutes and between different times(P>0.05).For the convex array probe,in 2023,the lateral resolution[2(2,2)]of the 70mm target group,and the axial and lateral resolutions[1(1,1)and 3(3,3.25)]of the 120mm target group of our institute were different with the lateral resolution[2(1,2)]of the 70mm target group,and the axial and lateral resolutions[2(2,3)and 2(2,3)]of the 120mm target group of Jiangsu Institute of Metrology,and the differences of them between our institute and Jiangsu Institute of Metrology were significant(Z=-2.887,-2.53,-3.69,P<0.05),respectively.In our institute,the axial and lateral resolutions[1(1,2)and 2.5(2,3)]of the 70mm target group,and the axial resolution[1(1,2)]of the 120mm target group in 2022 were different with the axial and lateral resolutions[1(1,1)and 2(2,2)]of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2023,and the differences of them between two years were significant(Z=-3.317,-3.419,-2.982,P<0.05).In Jiangsu Institute of Metrology,the lateral resolutions of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2022 year were different with those in 2023 year,and the differences of them were significant(Z=-2.333,-3.051,P<0.05),respectively.Conclusion:The interpretation for lateral resolution of convex array probe in target group with high depth,the difference of subjective interpretation criteria will cause the essential difference of final results.This paper suggested that the key image should be retained when the resolution of the image of target group with high depth of the convex array probe is interpreted.At the later stage,artificial intelligence(AI)-assisted quality control can also be introduced to conduct objective interpretation by computers.

Objective:To explore the correlation between the oxygenation index and the monitored parameters of lung injury view in ventilator,so as to provide a basis for monitoring the change of oxygenation index by the parameters of lung injury view.Methods:A total of 28 patients who received mechanical ventilation treatment and admitted to respiratory department of the First Affiliated Hospital with Nanjing Medical University from May 14 to September 30,2024 were selected.The monitored parameters of lung injury views of them during mechanical ventilation treatment with invasive ventilators were collected,including platform pressure(Pplat),driving pressure(ΔP),mechanical energy(Emech),ratio of tidal volume to ideal body weight(TVe/IBW),etc..Then,the data of oxygenation index were obtained.Finally,135 valid data were screened out.The 84 pieces of data with oxygenation index≤300mmHg were included in low oxygen group,and 51 data with oxygenation index>300mmHg were included in normal group.The correlations between oxygenation index and Pplat,ΔP,Emech,TVe/IBW were conducted by pairwise analysis.Results:In the low oxygen group,the oxygenation index was[(196.302±74.522)mmHg]significantly negative correlation with Emech[(12.686±5.401)J/min](ρ=-0.425,P<0.05),but not was significant correlation with Pplat,ΔP,and TVe/IBW(P>0.05).In the normal group,there were not significant correlations between the oxygenation index and Pplat,ΔP,Emech and TVe/IBW(P>0.05).There was a significant negative correlation between Emech and rank of oxygenation index(β=-0.389,P<0.05)in the low oxygen group.Conclusion:The visualization function of the Emech of the monitored parameters in lung injury view of ventilator can provide help for monitoring the changes of oxygenation index of patients in the low oxygen group,and can improve the oxygenation of patients by optimizing mechanical energy.However,it is necessary to balance the contradiction between ventilation intensity and protection for lung.

Objective:To investigate the relationship between intra-abdominal pressure (IAP) and respiratory function in mechanically ventilated children with severe pneumonia and its prognostic value.Methods:A case-series study.Ninety-two children with severe pneumonia who were treated with mechanical ventilation in the Intensive Care Unit of Children′s Hospital Affiliated to Zhengzhou University from May 2019 to May 2021 were taken as the study subjects.The IAP and respiratory function-related indexes of the children were monitored.Those with IAP ≥12 mmHg(1 mmHg=0.133 kPa) were divided into the study group, and those with IAP <12 mmHg were divided into the control group.The difference in respiratory function related indexes between the 2 groups was compared, and the relationship between IAP and respiratory function indexes was analyzed by Pearson correlation.The children were divided into a good prognosis group and a poor prognosis group according to their prognosis.The relevant clinical data of the children in the 2 groups were collected for univariate analysis, and multivariate Logistic regression was used to analyze the risk factors affecting the prognosis of children with mechanical ventilation for severe pneumonia.A receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of IAP on the prognosis of mechanically ventilated children with severe pneumonia.Results:The arterial partial pressure of oxygen (PaO 2) [(80.15±8.23) mmHg], arterial blood oxygen saturation (SaO 2) [(91.32±2.13)%], and oxygenation index (PaO 2/FiO 2) [(198.29±20.25) mmHg] in the study group were lower than those in the control group [(85.74±8.42) mmHg, (97.05±2.47)%, and (234.84±25.24) mmHg], while the respiratory rate (RR) [(56.23±2.16) breaths/min vs. (50.41±2.24) breaths/min], partial pressure of carbon dioxide (PaCO 2) [(36.48±3.72) mmHg vs.(33.29±3.46) mmHg], fraction of inspired oxygen (FiO 2) [(40.42±4.25)% vs.(36.51±3.72)%], mean arterial pressure (MAP) [(55.98±5.69) mmHg vs.(52.79±5.43) mmHg], and positive end expiratory pressure (PEEP) [(5.03±0.52) cmH 2O vs.(4.52±0.47) cmH 2O, 1 cmH 2O=0.098 kPa] were higher than those in the control group, and the differences were all statistically significant (all P<0.05).The IAP of the children in the study group was (14.25±1.83) mmHg, and that in the control group was (10.38±1.14) mmHg.Pearson correlation analysis showed that IAP was negatively correlated with PaO 2, SaO 2, and PaO 2/FiO 2 ( r=-0.615, -0.587, and -0.647, all P<0.05), and was positively correlated with RR, PaCO 2, FiO 2, MAP, and PEEP ( r=0.618, 0.634, 0.579, 0.578, 0.593, all P<0.05).IAP [(14.76±1.58) mmHg], PaCO 2 [(39.95±4.21) mmHg], FiO 2 [(50.29±5.12)%], alanine aminotransferase[(42.08±4.15) U/L], and total bilirubin [(17.92±1.87) μmol/L] in the poor prognosis group were greater than those [(10.75±1.19) mmHg, (35.37±3.64) mmHg, (45.38±4.47)%, (39.87±4.06) U/L, and (17.09±1.75) μmol/L] in the good prognosis group, while PaO 2 [(65.42±7.86) mmHg vs.(76.42±7.51) mmHg], SaO 2 [(90.65±9.26)% vs.(96.21±2.19)%], and PaO 2/FiO 2 [(130.09±15.15) mmHg vs.(168.40±20.17) mmHg] were smaller than those in the good prognosis group, and the differences were statistically significant (all P<0.05).Logistic regression analysis showed that IAP, PaO 2, PaCO 2, and SaO 2 were risk factors affecting the prognosis of mechanically ventilated children with severe pneumonia (all P<0.05).The optimal cut-off point of IAP for predicting a poor prognosis in mechanically ventilated children with severe pneumonia was 14.55 mmHg, and the area under the ROC curve was 0.873, with a sensitivity of 88.10% and a specificity of 76.00%. Conclusions:IAP has a certain relationship with the respiratory function of mechanically ventilated children with severe pneumonia, and has a good predictive value for the prognosis of the children.

Objective:To investigate the clinical characteristics and prognosis of silicosis complicated with cavity-pulmonary tuberculosis.Methods:The clinical data of 63 patients with silicosis complicated with cavity-pulmonary tuberculosis (group A) and silicosis patients (group B) admitted to Yantaishan Hospital from July 2018 to July 2022 were collected and analyzed.Results:Patients in group A were all male, and the common symptoms were cough, expectoration, chest tightness, shortness of breath, and hemoptysis. CT cavity lesions involving the lung, often occurs in the lung after the tip section, after the back section and basal segment, thick-walled cavity, may be accompanied by satellite lesions, endobronchial spread focal, pneumothorax, pleural effusion, etc. 1225 cases of group B patients haemoptysis of 59 patients, cavity in 3 patients, haemoptysis and/or cavity rate was lower than that in group A, the difference was statistically significant ( P<0.05) . In group A, CT reexamination 6-24 months after anti-tuberculosis treatment showed that 52 cases (82.5%) had cavity reduction/healing, 8 cases (12.7%) had recurrence, and 3 cases (4.8%) had damaged lung (2 died) . Conclusion:Silicosis patients with hemoptysis and/or CT in cavity should be more vigilant about combined tuberculosis, anti-tuberculosis treatment and/or dynamic CT follow-up helps laboratory diagnosis negative patients.

Objective:To investigate the clinical characteristics and prognosis of silicosis complicated with cavity-pulmonary tuberculosis.Methods:The clinical data of 63 patients with silicosis complicated with cavity-pulmonary tuberculosis (group A) and silicosis patients (group B) admitted to Yantaishan Hospital from July 2018 to July 2022 were collected and analyzed.Results:Patients in group A were all male, and the common symptoms were cough, expectoration, chest tightness, shortness of breath, and hemoptysis. CT cavity lesions involving the lung, often occurs in the lung after the tip section, after the back section and basal segment, thick-walled cavity, may be accompanied by satellite lesions, endobronchial spread focal, pneumothorax, pleural effusion, etc. 1225 cases of group B patients haemoptysis of 59 patients, cavity in 3 patients, haemoptysis and/or cavity rate was lower than that in group A, the difference was statistically significant ( P<0.05) . In group A, CT reexamination 6-24 months after anti-tuberculosis treatment showed that 52 cases (82.5%) had cavity reduction/healing, 8 cases (12.7%) had recurrence, and 3 cases (4.8%) had damaged lung (2 died) . Conclusion:Silicosis patients with hemoptysis and/or CT in cavity should be more vigilant about combined tuberculosis, anti-tuberculosis treatment and/or dynamic CT follow-up helps laboratory diagnosis negative patients.

Objective To investigate the effect of bronchoscopic balloon dilation treatment of different intervals on the tracheal intubation-induced subglottic stenosis in children. Methods Children with tracheal intubation-induced subglottic cicatricial stenosis were selected as the research objects. Among the 36 children with pure balloon dilation treatment, 20 cases were enrolled in the observation group and 16 cases were enrolled in the control group. In the observation group, electronic bronchoscopy was performed at 3 days after the first-time balloon dilation treatment, and those with grade 2 or higher stenosis received the second-time balloon dilation treatment. The follow-up treatment principle was as follows. If there was obvious retraction compared with the previous time and the stenosis was grade 2 or higher, the balloon dilation treatment would be performed again after an interval of 3 days; if there was no obvious retraction, the evaluation would be performed again after an interval of 2 weeks until there was no obvious retraction in the stenosis site under endoscopy for 3 times in 6 consecutive weeks, and the degree of stenosis was less than 25%, and then the electronic bronchoscopy evaluation would be stopped. In the control group, electronic bronchoscopy was performed 7 days after the first-time balloon dilation treatment, and those with grade 2 or higher stenosis received the second-time balloon dilation treatment. The follow-up treatment principle was as follows. If there was obvious retraction compared with the previous time and the stenosis was grade 2 or higher, the balloon dilation treatment would be performed again after an interval of 7 days; the evaluation method for those without obvious retraction was the same as the observation group. The follow-up duration ranged from 6 to 9 months. Results There was no significant difference in the total number of treatments and outcomes between the two groups (P>0.05). The treatment duration of the observation group was significantly shorter than that of the control group (P < 0.05). There were no significant differences in intraoperative complications such as bleeding, oxygen saturation decrease, heart rate decrease, and blood pressure decrease during anesthesia between the two groups (P>0.05). There were no significant differences in postoperative fever, aggravated laryngeal stridor, and dyspnea between the two groups (P>0.05). There were no significant differences in dyspnea, activity tolerance, and the need for long-term oxygen therapy between the two groups (P>0.05). Conclusion Most of the tracheal intubation-induced subglottic cicatricial stenosis in children has a good medium- and long-term effect through pure balloon dilation treatment. Shortening the interval of pure balloon dilation to 3 days can shorten the total treatment duration, alleviate the psychological burden of parents, but does not increase their economic burden. There are no significant differences in intraoperative and postoperative complications, outcomes, and long-term follow-up compared with the original interval of 5 to 7 days.

OBJECTIVE To optimize the water extraction process of Flos Lonicerae-Fructus Forsythuae and determine the range of water extraction process parameters.METHODS The active components were screened by network pharmacology,and the indica-tor ingredients were determined in combination with the quality markers under the relevant terms of Chinese Pharmacopoeia 2020 edition and the literature.Take extraction yield and the extraction rate of the indicative component as the critical quality attributes of the water extraction process to screen critical process parameters.The mathematical model was established by Box-Behnken experimental design to investigate the interaction between CQAs and CPPs and build the design space of the water extraction process of Flos Lonicerae-Fruc-tus Forsythuae.RESULTS The extraction percentages of phenolic acids,forsythoside A and forsythin were screened as the index components;specifications of medicinal slices,extraction time and water addition were the key process parameters.Based on the estab-lishment and optimization of the design space,the optimum water extraction process was obtained as follows:the medicinal slice of Lian-Qiao was broken into 0.8-1.2 cm,adding 12 times the amount of water in the first and extract for 30-50 min,10 times the a-mount of water in the second and extract for 25-30 min.CONCLUSION The verification results show that the measured value ob-tained by using the design space method to optimize the water extraction process is close to the predicted value,indicating that the method is stable and reliable,which can provide ideas for its further process development and quality control for the couple medicines of Flos Lonicerae-Fructus Forsythuae.