Objective:To investigate the changes of respiratory function and lung volume after bariatric surgery using spiral CT three-dimensional imaging technology.Methods:Using the prospective study method, the medical records of 30 subjects undergoing sleeve gastrectomy (LSG) in the Eighth Department of General Surgery, the Second Hospital of Hebei Medical University from Jan. 2023 to Jun. 2024 were collected. Among them, 12 were males and 18 were females, aged from 20 to 45 years, with the average age of 31.1 years old. Chest CT scans were completed within 1 week before surgery and 6 months after surgery. The subject′s CT plain scan reconstructed thin-layer images of the mediastinal window were transferred to a GE workstation, and the lung volumes of both lungs and each lobe and the tracheal wall area of the five bronchial segments (RB1, RB4, RB10, LB1 + 2 and LB10) were calculated as a percentage of the airway cross-sectional area (WA%), and the posterior intercostal position corresponding to the diaphragm was recorded. Paired t-test and rank-sum test were used to compare preoperative and postoperative differences.Results:Compared with pre-operation, the subject′s body mass index decreased significantly 6 months after bariatric surgery [(42.22±7.31) kg/m 2vs (30.12±5.59) kg/m 2,t=7.31, P<0.001)]. Except for left lower lobe [(1.15±0.23) L vs (1.27±0.24) L, t=1.97, P=0.054] and right middle lobe [(0.57±0.16) L vs (0.83±0.16) L, t=1.38, P=0.172], the remaining lung parts were significantly larger after surgery than before surgery: right upper lobe [(0.80±0.17) L vs (0.94±0.19) L, t=2.79, P=0.007], right lower lobe [(1.08±0.14) L vs (1.22±0.19) L, t=3.23, P=0.002], left upper lobe [(1.12±0.20) L vs (1.24±0.23) L, t=2.26, P=0.014]. Overall, right lung volume [(2.44±0.33) L vs (2.79±0.41) L, t=3.62, P=0.001], left lung volume [(2.27±0.36) L vs (2.52±0.39) L, t=2.53, P=0.014] and total lung volume [(4.71±0.60) L vs (5.30±0.71) L, t=3.48, P=0.001] all increased significantly at 6 months after surgery compared with before surgery. All five segments of bronchus (WA%) were significantly reduced after surgery than before surgery: RB1: [(62.82±4.66) vs (66.85±3.99), t=3.60, P=0.001]; RB4: [(61.24±5.28) vs (64.31±5.51), t=2.20, P=0.031]; RB10: [(60.03±4.64) vs (62.97±5.73), t=2.18, P=0.033]; LB1+ 2: [(63.61±5.05) vs (67.90±4.30), t=3.54, P=0.001]; LB10: [(58.73±6.49) vs (62.01±5.06), t=2.17, P=0.034)]. The posterior intercostal position corresponding to the diaphragm dropped from an average of 7-8 intercostal spaces to 8-9 intercostal spaces, with a significant difference (rank mean 22.77 vs 38.23, Z=-3.67, P<0.001). Conclusion:Bariatric surgery can significantly reduce weight, reduce the pressure of chest and abdominal, improve lung compliance, reduce the internal pressure of the chest, lower the diaphragm, expand the lung volume and airway cross-sectional area, restore the original airway anatomy and respiratory physiology, so it can effectively improve the respiratory function and lung structure abnormalities caused by obesity.

Objective To investigate the influence of oxygen supply flow rate in high-flow nasal cannula(HFNC)oxygen therapy on pressure distributions in the upper airway.Methods A three-dimensional(3D)model of the upper airway was reconstructed using CT images from an adult male,and then coupled with a high-flow nasal cannula model to establish a coupled model of the nasal cannula and the upper airway.Subsequently,a physical model of this upper airway,which was combined with a head model,artificial lungs,and a monitoring system was created by 3D printing technology to form a physical simulation platform in vitro.Computational and physical simulations were carried out respectively to determine the air pressure at typical locations in the upper airway under different oxygen supply flow rates.Results Pressures at typical upper airway locations obtained by computational and physical simulations turned out to be in good agreement;both peak inspirational pressure(PIP)and positive end-expiratory pressure(PEEP)increased quadratically with the increase of oxygen supply flow rate;and the air pressure distribution was more uniform in the laryngeal cross-section as compared to the nasal part of the upper airway.Conclusions This study may provide a theoretical support for optimization of the setting of oxygen suppy flow rate and the selection of PEEP effect assessment position in the clinical application of HFNC oxygen therapy.

Objective To propose a transfer learning-based method for breath sound feature recognition and autonomous determination of sputum suction timing.Methods An electronic stethoscope was used to collect breath sounds from the main airways of clinically ventilated patients before and after sputum suction,with pre-suction breath sounds labeled as requiring suction.The collected data underwent high-pass filtering and wavelet soft-threshold denoising,followed by the extraction of log-Mel spectrograms.A VGGish model pretrained on the Audio Set dataset was then employed to extract feature vectors from these spectrograms,which were subsequently classified using a support vector machine to determine whether suction was required.Results The precision,recall and F1 score for recognition of breath sounds requiring sputum suction were 86.73％,93.06％and 89.78％,respectively.Conclusions The proposed breath sound recognition method based on transfer learning effectively determines the timing of sputum suction and shows a significant clinical potential.

Objective To investigate the effect and mechanism of long non-coding RNA(lncRNA)NRON on myocardial fibrosis in mice with myocardial infarction(MI).Methods Thirty-two C57/BL6 mice were randomly assigned to a Sham group,MI group,MI+shNRON group or MI+NC group,with eight mice in each group.The expression level of lncRNA NRON in myocardial tissue of mice was detected by real-time quantitative PCR.Hematoxylin and eosin staining,Masson's trichrome staining,and immunohistochemistry were used to detect the degree of myocardial injury,myocardial fibrosis,and the expression level of collagen Type Ⅰ(col Ⅰ).Western blotting was used to detect the protein expression levels of TGF-β1,p-Smad2,and p-Smad3 in myocardial tissue of the mice.Results Compared with the Sham group,the expression of NRON,col Ⅰ,TGF-β1,p-Smad2,and p-Smad3 proteins were increased in the MI group.Compared with the MI group,the expression of NRON,the degree of myocardial damage and fibrosis,the expression of col Ⅰ,TGF-β1,p-Smad2,and p-Smad3 proteins were decreased in the MI+shNRON group.Conclusion Down-regulation of lncRNA NRON can alleviate myocardial injury and inhibit myocardial fibrosis in mice with MI,and the molecular mechanism may be related to inhibition of the TGF-β/Smad signaling pathway.

Objective To propose a transfer learning-based method for breath sound feature recognition and autonomous determination of sputum suction timing.Methods An electronic stethoscope was used to collect breath sounds from the main airways of clinically ventilated patients before and after sputum suction,with pre-suction breath sounds labeled as requiring suction.The collected data underwent high-pass filtering and wavelet soft-threshold denoising,followed by the extraction of log-Mel spectrograms.A VGGish model pretrained on the Audio Set dataset was then employed to extract feature vectors from these spectrograms,which were subsequently classified using a support vector machine to determine whether suction was required.Results The precision,recall and F1 score for recognition of breath sounds requiring sputum suction were 86.73％,93.06％and 89.78％,respectively.Conclusions The proposed breath sound recognition method based on transfer learning effectively determines the timing of sputum suction and shows a significant clinical potential.

Objective To investigate the effect and mechanism of long non-coding RNA(lncRNA)NRON on myocardial fibrosis in mice with myocardial infarction(MI).Methods Thirty-two C57/BL6 mice were randomly assigned to a Sham group,MI group,MI+shNRON group or MI+NC group,with eight mice in each group.The expression level of lncRNA NRON in myocardial tissue of mice was detected by real-time quantitative PCR.Hematoxylin and eosin staining,Masson's trichrome staining,and immunohistochemistry were used to detect the degree of myocardial injury,myocardial fibrosis,and the expression level of collagen Type Ⅰ(col Ⅰ).Western blotting was used to detect the protein expression levels of TGF-β1,p-Smad2,and p-Smad3 in myocardial tissue of the mice.Results Compared with the Sham group,the expression of NRON,col Ⅰ,TGF-β1,p-Smad2,and p-Smad3 proteins were increased in the MI group.Compared with the MI group,the expression of NRON,the degree of myocardial damage and fibrosis,the expression of col Ⅰ,TGF-β1,p-Smad2,and p-Smad3 proteins were decreased in the MI+shNRON group.Conclusion Down-regulation of lncRNA NRON can alleviate myocardial injury and inhibit myocardial fibrosis in mice with MI,and the molecular mechanism may be related to inhibition of the TGF-β/Smad signaling pathway.

Objective To investigate the influence of oxygen supply flow rate in high-flow nasal cannula(HFNC)oxygen therapy on pressure distributions in the upper airway.Methods A three-dimensional(3D)model of the upper airway was reconstructed using CT images from an adult male,and then coupled with a high-flow nasal cannula model to establish a coupled model of the nasal cannula and the upper airway.Subsequently,a physical model of this upper airway,which was combined with a head model,artificial lungs,and a monitoring system was created by 3D printing technology to form a physical simulation platform in vitro.Computational and physical simulations were carried out respectively to determine the air pressure at typical locations in the upper airway under different oxygen supply flow rates.Results Pressures at typical upper airway locations obtained by computational and physical simulations turned out to be in good agreement;both peak inspirational pressure(PIP)and positive end-expiratory pressure(PEEP)increased quadratically with the increase of oxygen supply flow rate;and the air pressure distribution was more uniform in the laryngeal cross-section as compared to the nasal part of the upper airway.Conclusions This study may provide a theoretical support for optimization of the setting of oxygen suppy flow rate and the selection of PEEP effect assessment position in the clinical application of HFNC oxygen therapy.

Objective:To explore the risk factors for lymphoproliferative disorders (PTLD) in children with thalassemia major (TM) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:This was a retrospective case-control study.A total of 482 children with TM who underwent allo-HSCT at Shenzhen Children′s Hospital between January 2020 and December 2022 were selected and classified into the PTLD and non-PTLD groups according to the occurrence of PTLD.The risk factors for PTLD after allo-HSCT in children with TM were analyzed, and the diagnostic efficiency of relevant risk factors for PTLD was analyzed by receiver operating characteristic (ROC) curve.Results:A total of 25 out of 482 patients (5.2%, 25/482) developed PTLD about 114 (54-271) days after allo-HSCT.Among them, 12 cases (12/25, 48.0%) occurred within 100 days, and 22 cases (22/25, 88.0%) occurred within 1 year after allo-HSCT.Univariate analysis showed that there were significant differences in gender composition, type of transplant donor, number of natural killer cells and B lymphocytes in peripheral blood at 30 days after allo-HSCT, positive rate of plasma Epstein-Barr virus deoxyribonucleic acid (EBV-DNA) and incidence rate of acute graft-versus-host disease (aGVHD) between the 2 groups (all P<0.05).Multivariate Logistic regression analysis showed that female ( OR=3.196, 95% CI: 1.144-8.929), positive plasma EBV-DNA ( OR=17.523, 95% CI: 5.449-56.344) and aGVHD ( OR=3.156, 95% CI: 1.161-8.575) were independent risk factors for PTLD after allo-HSCT in TM children (all P<0.05).The ROC curve analysis showed that positive plasma EBV-DNA had an excellent accuracy in predicting the occurrence of PTLD after allo-HSCT (sensitivity was 0.796, specificity was 0.800, area under the curve was 0.803).If combined with aGVHD and gender, the area under the curve for the prediction of PTLD increased to 0.831. Conclusions:Female, positive plasma EBV-DNA and aGVHD are independent risk factors for PTLD after allo-HSCT in children with TM.It provides useful early warnings for the prediction and prevention of PTLD.

This study explores the application of animation in medical teaching. On the one hand, the status quo of the application of animation in medical teaching was analyzed by conducting questionnaire survey for the effect of animation-enhanced teaching of the biology course; on the other hand, new animations were made by the researchers to analyze its effect on the students' self-study. The results showed that the scores of the students receiving text and teaching animation resources were significantly higher than that of students receiving only textual information in the learning process (P<0.01), and the same goes for the number of the students that complete the >75％ of the learning content. The results showed that the teaching animation can improve the students' self-study performance and raise their interest in self-study.

Objective Analysis the expression and significance of P16INK4 ,P57kip2 and Ki67 in hepatocellular carcinoma .Meth-ods 21 normal liver tissue ,48 hepatocellular carcinoma tissues and 48 corresponding adjacent tissue were collected for this study . Immunohistochemical analysis the expression levels of P16INK4 ,P57kip2 and Ki67 .Results P16INK4 and P57kip2 in hepatocellular carci-noma tissue were significantly lower ,the positive rates were 49 .3% and 34 .2% respectively ,Ki67 was significantly higher than the normal liver tissue and corresponding adjacent tissue ,the difference was statistically significant(P<0 .05) ,the results were consist-ent with the Western blot ;different differentiated group p57kip2 ,Ki67 expression and P16INK4 were significant differences(P<0 .05) . Conclusion Low expression of P16INK4 and P57kip2 ,the higher expression of Ki67 play an important role in the development of hepa-tocellular carcinoma .