Objective:To investigate the key targets and mechanisms of compound Huangbai liquid in promoting wound healing of perianal abscess using network pharmacology and machine learning.Methods:Active components of compound Huangbai liquid and their target genes were screened and corrected using the TCMSP and HERB databases.Target genes related to wound healing were collected from the GeneCard and GEO databases.Common targets were identified using SangerBox online tool,followed by KEGG and GO enrichment analyses to explore potential biological functions.A PPI network was constructed to analyze core gene interactions,and immune cell infiltration was evaluated using the CIBERSORT algorithm.Key genes were screened using machine learning methods such as Boruta,random forest,XGBoost,and SVM-RFE.Finally,the binding affinity between active components and target genes was validated using AutoDock Vina.Results:Four key target genes(CYP19A1,IL10RA,ALOXE3,EGFR)were significantly correlated with components such as quercetin and berberine.These genes were involved in PI3K-Akt signaling pathway,and closely related to immune response and cell proliferation.The PPI network showed that these genes played important roles in angiogenesis and cell adhesion.Immune infiltration analysis showed that key genes were strongly correlated with immune cells such as macrophages.Conclusion:Compound Huangbai liquid may promote wound healing in perianal abscess by regulating multiple biological pathways and immune responses.

Objective:To investigate the key targets and mechanisms of compound Huangbai liquid in promoting wound healing of perianal abscess using network pharmacology and machine learning.Methods:Active components of compound Huangbai liquid and their target genes were screened and corrected using the TCMSP and HERB databases.Target genes related to wound healing were collected from the GeneCard and GEO databases.Common targets were identified using SangerBox online tool,followed by KEGG and GO enrichment analyses to explore potential biological functions.A PPI network was constructed to analyze core gene interactions,and immune cell infiltration was evaluated using the CIBERSORT algorithm.Key genes were screened using machine learning methods such as Boruta,random forest,XGBoost,and SVM-RFE.Finally,the binding affinity between active components and target genes was validated using AutoDock Vina.Results:Four key target genes(CYP19A1,IL10RA,ALOXE3,EGFR)were significantly correlated with components such as quercetin and berberine.These genes were involved in PI3K-Akt signaling pathway,and closely related to immune response and cell proliferation.The PPI network showed that these genes played important roles in angiogenesis and cell adhesion.Immune infiltration analysis showed that key genes were strongly correlated with immune cells such as macrophages.Conclusion:Compound Huangbai liquid may promote wound healing in perianal abscess by regulating multiple biological pathways and immune responses.

Objective:To evaluate the optimization strategy of anesthesia for laparoscopic nephrectomy in elderly patients using ultrasound-guided erector spinae plane block combined with total intravenous anesthesia.Methods:This was a prospective randomized controlled study. Seventy elderly patients, aged 60-80 yr, with a body mass index of 22-30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, scheduled for elective/limited laparoscopic nephrectomy under total intravenous anesthesia in our hospital from April to October 2023, were divided into a total intravenous anesthesia group (TIVA group) and an ultrasound-guided erector spinae plane block combined with total intravenous anesthesia group (ESPB group) using a random number table method, with 35 cases in each group. Two groups used the same general anesthesia regimen. The ultrasound-guided erector spinae plane block was performed at the T 11 level after general anesthesia, and 0.3% ropivacaine 30 ml was injected after the successful puncture in ESPB group. The postoperative quality of recovery was assessed using the 15-item Quality-of-Recovery scale. The postoperative rescue analgesia and occurrence of adverse reactions were recorded. Results:Compared with TIVA group, the 15-item Quality-of-Recovery scale score was significantly increased, the rate of postoperative rescue analgesia was decreased, and the incidence of adverse reactions was decreased in ESPB group ( P<0.05). Conclusions:Ultrasound-guided erector spinae plane block combined with total intravenous anesthesia is beneficial for the postoperative outcomes of elderly patients undergoing laparoscopic nephrectomy.

Objective: To investigate the clinical characteristics, diagnosis, treatment and prognosis of therapy-related myeloid neoplasms (t-MNs) after successful treatment for acute promyelocytic leukemia (APL) . Methods: Clinical data of 4 patients, diagnosed as t-MNs secondary to APL at Hematology Hospital of Chinese Academy of Medical Sciences from October 2012 to January 2019, were collected retrospectively. T-MNs related literature was reviewed. Results: The 4 cases were all females, with the median age 42 (range 40-53) years old at the diagnosis of APL. Regarding the induction and consolidation regimens, 3 patients received all-trans retinoid acid (ATRA) and arsenic trioxide (ATO) combined with anthracycline/anthraquinone and/or cytosine. One patient only received ATRA and other auxiliary drugs. Alkylating agents were not administrated. The 4 patients developed t-MNs 40 to 43 months after complete remission (CR) of APL, including 1 case of therapy-related myelodysplastic syndrome (t-MDS) and 3 cases of acute myeloid leukemia (t-AML) . The PML-RARα fusion genes were all negative when t-MNs developed. The three patients with t-AML were treated with 3 to 4 re-induction regimens, one of whom underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) after complete remission (CR) . One patient with t-MDS received hypomethylating agents. After a median follow-up of 54.5 (48-62) months, 2 patients with t-AML died, the median overall survival after t-MN was 12 (5-18) months. From 1989 to 2018, a total of 63 t-MN cases were reported in the literature. Therefore, 67 cases were analyzed when four patients in our center were added, including 27 males and 40 females with median age 52.5 (15-76) years. The median latency was 39 (12-126) months and the median overall survival after diagnosis of t-MN was 10 (1-39) months. Conclusions Although rare, t-MNs may occur after successful control of APL. There are no existing guidelines for prevention and treatment of t-MNs, which have very poor prognosis. If cytopenia or other abnormalities of peripheral blood cells develop after 3 years of APL, t-MNs should be considered as a differential diagnosis.

Objective To evaluate the influence of head anteflexion on airway sealing pressure during intermittent positive pressure ventilation(IPPV) with ProSeal laryngeal mask airway (PLMA) with an esophageal vent.Methods Fifty ASA Ⅰ or Ⅱ patients (20 males and 30 females), aged 18-51 ye are, weighing 50-70 kg and scheduled for elective plastic surgery under general anesthesia, were enrolled in this study. Anesthesia was induced with fentanyl 2 μg/kg, propofol 2 μg/kg and vecuromium 0.1 mg/kg. PLMA with an esophageal vent was inserted at 2 min after intravenous vecuronium injection.The airway sealing pressure, the anatomic position of the cuff and the efficacy of positive pressure ventilation were checked in the neutral and anteflexed head positions with the cuff deflated and inflated to an intracuff pressure of 60 cm H2 O, respectively.Results The lungs were better ventilated in the head anteflexion position than in the head neutral position whether the cuff was deflated or inflated. There was no significant difference in the volume of air required to achieve an intracuff pressure of 60 cm H2O between the two head positions ( P＞ 0.05). The airway seating pressure increased from (27 ± 6) cm H2O in the head neutral position to (33 ± 6) cm H2O in the head anteflexion position, with no significant difference between them ( P＞ 0.05). The expired tidal volume and the peak inspiratory pressure during IPPV were (496 ± 81 ) ml and (14.3 ± 1.9) cm H2O respectively in the head neutral position and (496 ± 81 ) ml and ( 14.5 ± 2.1 )cm H2O respectively in the head anteflexion position.Conclusion Head anteflexion can significantly improve airway sealing but does not affect the anatomic position of the cuff.Appropriate head anteflexion is a simple and effective way to improve IPPV when the airway sealing pressure is inadequate in the head neutral position.

Objective To compare the effects of small dose remifentanil and fentanyl on hemodynamic responses to orotracheal intubation in children.Methods Ninety ASAⅠorⅡchildren (57 males, 33 females) aged 3-9 yrs weighing 17-34 kg scheduled for elective plastic surgery under general anesthesia were randomly allocated to one of 3 groups (n = 30 each): groupⅠcontrol (C); groupⅡfentanyl (F) and groupⅢremifentanil (R) . The children were premedicated with intramuscular scopolamine 0.01 mg?kg-1(the maximum dose 0.3 mg) and midazolam 0.1 mg?kg-1.Anesthesia was induced with propofol 2.5 mg?kg-1 and vecuronium 0.1 mg?kg-1. In group F fentanyl 2?g?kg-1 was injectedⅣ5 min before intubation while in group R remifentanil 1?g?kg-1 was injectedⅣover 30 seconds immediately after vecuronium. Tracheal intubation was performed at 2 min after vecuronium injection. Noninvasive BP and HR were recorded and RPP (SBP?HR) was calculated before (baseline) and immediately after induction (T1),during intubation (T2) and at 1,2,3,4, 5 min after intubation.Results BP was significantly decreased after induction of anesthesia (T1) as compared to the baseline values in all 3 groups (P