Objective To investigate the lung protection effect of remazolam under lung protection ventilation strategy in elderly patients undergoing laparoscopic upper abdominal surgery.Methods A prospective randomized controlled study was conducted on 60 patients aged 60 years or older who were scheduled to undergo laparoscopic upper abdominal surgery,including cholecystectomy,common bile duct choledocholithotomy,partial hepatectomy,and subtotal gastrectomy from October 2023 to October 2024.The patients were divided into 2 groups by random number table method:30 patients in the observation group received lung protective ventilation strategy and remazolam administration,and 30 patients in the control group received lung protective ventilation strategy and propofol administration.The inflammatory response indexes(TNF-α,IL-6,and hs-CRP),stress indexes(SOD,NE,and Cor),anesthesia quality(VAS score and Ramsay score),lung function(FVC,FEV1,and MVV％),blood gas indexes(pH,Lac,PaO2,and PaCO2),recovery quality(tracheal tube extubation time,respiratory recovery time,and awakening time),and pulmonary complications were compared between the two groups.Results In the observation group,the serum levels of inflammatory markers of TNF-α,IL-6,and hs-CRP at 2,12,and 24 h postoperatively were all lower than those in the control group(all P=0.000).Regarding stress response indicators,the serum SOD levels in the observation group were higher than those in the control group at 2,12,and 24 h postoperatively,while the NE and Cor levels were lower(all P=0.000).The VAS scores at 24 h postoperatively,and the Ramsay scores at 2 and 24 h postoperatively in the observation group were lower than those in the control group(all P=0.000).In the observation group,the FVC,FEV1,and MVV％were all higher than those in the control group at 48 h postoperatively(P＜0.05).The PaO2 level in the observation group was higher than that in the control group at 24 h postoperatively,and the Lac level was lower(P＜0.05).The respiratory recovery time and awakening time in the observation group were both shorter than those in the control group(P＜0.05).There were no significant differences between the two groups in extubation time and pulmonary complications(P＞0.05).Conclusions The lung protection effect of remazolam under lung protection ventilation strategy is better than that of propofol in elderly patients undergoing laparoscopic upper abdominal surgery.The lung protective effects may be achieved by alleviating perioperative stress response,improving oxygenation function,effective sedation,and reducing inflammatory response.

Objective To investigate the lung protection effect of remazolam under lung protection ventilation strategy in elderly patients undergoing laparoscopic upper abdominal surgery.Methods A prospective randomized controlled study was conducted on 60 patients aged 60 years or older who were scheduled to undergo laparoscopic upper abdominal surgery,including cholecystectomy,common bile duct choledocholithotomy,partial hepatectomy,and subtotal gastrectomy from October 2023 to October 2024.The patients were divided into 2 groups by random number table method:30 patients in the observation group received lung protective ventilation strategy and remazolam administration,and 30 patients in the control group received lung protective ventilation strategy and propofol administration.The inflammatory response indexes(TNF-α,IL-6,and hs-CRP),stress indexes(SOD,NE,and Cor),anesthesia quality(VAS score and Ramsay score),lung function(FVC,FEV1,and MVV％),blood gas indexes(pH,Lac,PaO2,and PaCO2),recovery quality(tracheal tube extubation time,respiratory recovery time,and awakening time),and pulmonary complications were compared between the two groups.Results In the observation group,the serum levels of inflammatory markers of TNF-α,IL-6,and hs-CRP at 2,12,and 24 h postoperatively were all lower than those in the control group(all P=0.000).Regarding stress response indicators,the serum SOD levels in the observation group were higher than those in the control group at 2,12,and 24 h postoperatively,while the NE and Cor levels were lower(all P=0.000).The VAS scores at 24 h postoperatively,and the Ramsay scores at 2 and 24 h postoperatively in the observation group were lower than those in the control group(all P=0.000).In the observation group,the FVC,FEV1,and MVV％were all higher than those in the control group at 48 h postoperatively(P＜0.05).The PaO2 level in the observation group was higher than that in the control group at 24 h postoperatively,and the Lac level was lower(P＜0.05).The respiratory recovery time and awakening time in the observation group were both shorter than those in the control group(P＜0.05).There were no significant differences between the two groups in extubation time and pulmonary complications(P＞0.05).Conclusions The lung protection effect of remazolam under lung protection ventilation strategy is better than that of propofol in elderly patients undergoing laparoscopic upper abdominal surgery.The lung protective effects may be achieved by alleviating perioperative stress response,improving oxygenation function,effective sedation,and reducing inflammatory response.

Objective:To investigate the effect and mechanism of Myosin X on the radiosensitivity of non-small cell lung cancer (NSCLC) cell line H1975 in vitro. Methods:Western blot was applied to detect the expression level of Myosin X expression. The H1975 cell line with stable knockout of Myosin X (KO group) and infected with control virus (NC group) were constucted by using CRISPR/Cas9 technique. The knockout efficiency was validated. The radiosensitivity of two cell lines was measured by colony formation assay and single-hit multi-target model. γ-H 2AX focus formation test and RNA sequencing (RNAseq) analysis were employed to identify the regulatory mechanism of the radiosensitivity of lung cancer cell lines mediated by Myosin X. Results:The expression level of Myosin X in the H1975 cells was significantly up-regulated than those in other NSCLC cell lines (all P<0.01). The lentiviral vector of Myosin X sgRNA-Lenti-CRISPR v2 was successfully constructed. After the puromycin screening, H1975 cell lines with complete knockout of Myosin X and control cell lines (NC group) were obtained. Colony formation assay demonstrated that compared with the NC group, the radiosensitivity in the KO group was significantly higher (The D 0 value was decreased from 1.28 Gy to 1.03 Gy, SF 2 decreased from 0.29 to 0.21, and the sensitization ratio was 1.24). The γ-H 2AX focus formation test showed that the number of damage focus formed at 1 h and 6 h after irradiation in the KO group was significantly larger than that in the NC group ( P<0.05. RNAseq analysis indicated that the expression level of ISLR in the KO group was significantly down-regulated than that IN the NC group ( P<0.05). Conclusion:Knockout of Myosin X can increase the radiosensitivity of H1975 cells probably by interfering the repair of DNA double-strand damage and down-regulating the expression level of ISLR.

BACKGROUND: Fibular fixation and tantalum rod implantation are two commonly used methods for the treatment of early osteonecrosis of the femoral head (ONFH), both of which can effectively delay or even reverse the progress of ONFH. However, further comparative evaluation on their mechanical properties and therapeutic efficacy is required.OBJECTIVE: To compare the clinical efficacy of fibular fixation and tantalum rod implantation on ONFH at early stage.METHODS: Fifty-eight patients (81 hips) suffered from ONFH with ARCO stage 1 and stage 2, and underwent fibular fixation (30 cases, 41 hips) or tantalum rod implantation (28 cases, 40 hips). Postoperatively, both groups were followed up for over 2 years. The Harris scores of the hip were compared between two groups before and after treatment. With femoral head collapse and the collapse distance > 4 mm as observation points, the survival rate of the femoral head was compared between two groups.RESULTS AND CONCLUSION: The postoperative Harris scores of the two groups were significantly improved than before (P < 0.05). With the appearance of femoral head collapse as the observation point, the Kaplan-Meier survival curve showed that the overall survival rate of the hip was 83% in the fibular fixation group and 65% in the tantalum rod implantation group. After examined by log-rank (Mantel-Cox), there was a significant difference in the survival rate of the hip at Stage IIC between two groups (P=0.0431). With > 4 mm collapse as the observation point, the Kaplan-Meier survival curve showed that overall survival rate of the hip was 95% in the fibular fixation group and 83% in the tantalum rod implantation group. After examined by log-rank (Mantel-Cox), there was a significant difference in the survival rate of the hip at Stage IIC between two groups (P=0.0418). To conclude, both fibular fixation and tantalum rods implantation applied to ONFH at early stage can effectively improve the hip function, and the survival rate of the hip at ARCO Stage IIC is better in patients undergoing fibular fixation than tantalum rod implantation.

Due to the air-filled alveoli and delicate vascular structure,the lung is the most easily damaged organ when human or animal is subjected to a shock wave.Primary pulmonary blast injury resulting from shock wave is an important cause of trauma not only in military conflicts but also in terrorism or accidents involving civilians.The physiological,pathological and biochemical changes after blast injury may lead to inflammatory response,cell apoptosis in the lung,boost the activation of cytokines including TNF-α,IL-6,IL-8 and IL-1β,and finally result in acute respiratory distress syndrome (ARDS).This paper presents the evolution and characteristics of pulmonary blast injury,and demonstrates four relevant experimental setups including biological shock tube,segmented shock wave generator,mini blast wave generator and laser-induced stress wave generator.Besides,this paper reviews the scoring system of pulmonary blast injury,pathological and biochemical measurement aiming to provide helpful reference to establish pulmonary blast injury models.