Background and purpose:Accurately locating pulmonary nodules is the key to the success of thoracoscopic surgery.This study aimed to investigate the strategy and evaluate the feasibility,safety,and clinical value of thoracoscopic surgical treatment for pulmonary nodules located beneath the interlobar pleura and close to the pulmonary hilum.Methods:The patients who underwent pulmonary nodule surgery at Liaocheng Tumor Hospital from May 2023 to November 2024 were enrolled,and the patients who did not meet the inclusion criteria were excluded.This study was approved by the Ethics Committee of Liaocheng Tumor Hospital(EC-20240112-1020)and informed consent was obtained from the patients.The research was designed as a prospective single-arm study.The patients were treated with wedge resection,which was performed following CT-guided localization,where the location needle was inserted through the interlobar pleura.The feasibility of the procedure was evaluated by analyzing the success rate of preoperative localization and perioperative complications.Results:A total of 28 patients who met the inclusion criteria were included in this study.There were 5 male and 23 female patients with an average age of(56.0±8.5)years(range 38-69 years).In all,28 patients with 28 nodules underwent thoracoscopic wedge resection,and the preoperative CT-guided localization was successfully performed in all patients,without urgent complications.The mean operation time of thoracoscopic surgery was(15.6±4.0)min,intraoperative bleeding was(20.9±14.3)mL,and postoperative drainage was(214.3±62.2)mL.No cases of postoperative air leaks or conversion to thoracotomy were observed.The average length of hospital stay was(5.4±0.9)days.The postoperative histological diagnosis revealed 3 benign lesions(pulmonary fibrosis in 2 cases,atypical adenomatous hyperplasia in 1 case)and 25 malignant lesions(adenocarcinoma in situ in 5 cases,minimally invasive adenocarcinoma in 16 cases,and invasive adenocarcinoma in 4 cases).Conclusion:Thoracoscopic wedge resection following CT-guided nodule localization through the interlobar pleura is a feasible approach for nodules located beneath the interlobar pleura and close to the pulmonary hilum.The method ensures precise tumor localization,adequate margin,and minimal loss of normal lung tissue,with a low incidence of postoperative complication,which has important guiding significance for the surgical treatment of pulmonary nodules in such special locations.

Background and purpose:Accurately locating pulmonary nodules is the key to the success of thoracoscopic surgery.This study aimed to investigate the strategy and evaluate the feasibility,safety,and clinical value of thoracoscopic surgical treatment for pulmonary nodules located beneath the interlobar pleura and close to the pulmonary hilum.Methods:The patients who underwent pulmonary nodule surgery at Liaocheng Tumor Hospital from May 2023 to November 2024 were enrolled,and the patients who did not meet the inclusion criteria were excluded.This study was approved by the Ethics Committee of Liaocheng Tumor Hospital(EC-20240112-1020)and informed consent was obtained from the patients.The research was designed as a prospective single-arm study.The patients were treated with wedge resection,which was performed following CT-guided localization,where the location needle was inserted through the interlobar pleura.The feasibility of the procedure was evaluated by analyzing the success rate of preoperative localization and perioperative complications.Results:A total of 28 patients who met the inclusion criteria were included in this study.There were 5 male and 23 female patients with an average age of(56.0±8.5)years(range 38-69 years).In all,28 patients with 28 nodules underwent thoracoscopic wedge resection,and the preoperative CT-guided localization was successfully performed in all patients,without urgent complications.The mean operation time of thoracoscopic surgery was(15.6±4.0)min,intraoperative bleeding was(20.9±14.3)mL,and postoperative drainage was(214.3±62.2)mL.No cases of postoperative air leaks or conversion to thoracotomy were observed.The average length of hospital stay was(5.4±0.9)days.The postoperative histological diagnosis revealed 3 benign lesions(pulmonary fibrosis in 2 cases,atypical adenomatous hyperplasia in 1 case)and 25 malignant lesions(adenocarcinoma in situ in 5 cases,minimally invasive adenocarcinoma in 16 cases,and invasive adenocarcinoma in 4 cases).Conclusion:Thoracoscopic wedge resection following CT-guided nodule localization through the interlobar pleura is a feasible approach for nodules located beneath the interlobar pleura and close to the pulmonary hilum.The method ensures precise tumor localization,adequate margin,and minimal loss of normal lung tissue,with a low incidence of postoperative complication,which has important guiding significance for the surgical treatment of pulmonary nodules in such special locations.

ObjectiveTo observe the clinical efficacy and safety of Tengfu Jiangya tablets combined with valsartan/amlodipine in the treatment of grade 2 hypertension with liver Yang hyperactivity syndrome. MethodAccording to a randomized，double-blind，and placebo parallel control method，288 patients with grade 2 hypertension with liver Yang hyperactivity from 7 subcenters were included. They were randomly divided into an observation group （144 cases） and a control group （144 cases），and then treated with Tengfu Jiangya tablets combined with valsartan/amlodipine and placebo combined with valsartan/amlodipine，respectively. The efficacy was evaluated after four weeks of intervention. During the experiment，the safety indicators and adverse reaction events of the subjects were recorded for safety evaluation，and the efficacy indicators and TCM syndrome scores were recorded for effectiveness evaluation. Sensitivity analysis was also conducted on the statistical results of the main efficacy indicators such as blood pressure （BP） compliance rate to ensure the accuracy of the analysis results. 88 groups of blood samples from each of the treatment and control groups were included as test subjects. Fasting blood samples were collected from the patients in the clinical trial on the day before and after medication，and enzyme linked immunosorbent assay （ELISA） was performed on the treated serum. The levels of arachidonic acid （AA），thromboxane B₂ （TXB₂），and prostaglandin E₂ （PGE₂） in the serum of the patients before and after treatment were measured to explore the regulation of inflammatory factors in the body by Tengfu Jiangya tablets. ResultA total of 271 patients （133 in the observation group and 138 in the control group） completed the trial. There was no statistically significant difference before and after treatment in such safety indicators as the blood routine （white blood cells，red blood cells，and platelets），urine routine （urinary protein and urinary red blood cells），alanine aminotransferase，aspartate aminotransferase，creatinine，urea，and abnormal electrocardiogram，and no serious adverse reactions were observed. After four weeks，the systolic blood pressure （SBP） difference and diastolic blood pressure （DBP） difference of patients in the observation group were greater than those in the control group（P<0.01）. According to the criteria for determining the antihypertensive effect，the overall response rate in the observation group［89.47%（119/133）］ was higher than that in the control group［57.97%（80/138）］ （Z=2.593，P<0.01）. The SBP compliance rate was 61.65%（82/133） and 37.68%（52/138） in the observation group and control group， respectively. The DBP compliance rate in the observation group was 78.20%（104/133），while in the control group it was 55.07%（76/138）. The overall BP compliance rate in the observation group was 48.12%（64/133），while in the control group it was 23.19%（32/138）. The BP compliance rates in the observation group were all significantly higher than those in the control group（χ²=15.571，16.236，18.404，P<0.01）. According to the criteria for evaluating the therapeutic effect of TCM syndrome integration，the overall response rate of the observation group［57.89%（77/133）］ was higher than that of the control group［38.41%（53/133）］ （Z=-3.172，P<0.01）.Compared with those before treatment， the levels of serum AA and TXB₂ in the two groups were significantly decreased after treatment （P<0.01）， and the level of PGE₂ in the observation group was significantly increased （P<0.01）. Compared with those of the control group after treatment， the levels of AA and TXB₂ in the observation group were significantly decreased， while the level of PGE₂ was significantly increased （P<0.01）. The results suggest that Tengfu Jiangya tablets can effectively reduce inflammatory factors，reduce the production of inflammatory mediators，and thus prevent the occurrence of inflammatory reactions in the treatment of patients with grade 2 hypertension. ConclusionTengfu Jiangya tablets can more effectively reduce patients' SBP and DBP，improve their BP compliance rates，and improve their TCM syndromes in the treatment of grade 2 hypertension with liver Yang hyperactivity. Its clinical application is safe. Tengfu Jiangya tablets has outstanding clinical efficacy and can be used as an effective intervention method for the treatment of grade 2 hypertension with liver Yang hyperactivity syndrome.

Objective:To investigate the application value of digital X-ray radiotherapy and single photon emission computed tomography(SPECT)radionuclide bone imaging in the diagnosis of intertrochanteric fracture of femur.Methods:A total of 70 patients who were diagnosed as intertrochanteric fracture of femur in Shijiazhuang People's hospital from January 2017 to December 2020 were selected,and they were divided into study group and control group according to random number method,with 35 cases in each group.Digital X-ray radiography combined with SPECT radionuclide bone imaging was used in the study group,and digital X-ray radiography was used in the control group.And then,the accuracy of the diagnostic results between the two groups were compared.Results:The radiographic examination indicated that 31 cases(88.6%)of 35 cases in the study group were confirmed,and 24 cases(68.6%)of 35 cases in the control group were confirmed.The diagnostic accuracy rate of the study group was significantly higher than that of the control group,and the difference was statistically significant(x2=4.158,P<0.05).The preoperative imaging diagnosis indicated that diagnosed number of fracture blocks in the study group was(3.57±0.50),which was significantly higher than that(2.67±0.40)in the control group,and the difference of that between two groups was statistically significant(t=8.315,P<0.05).In the actual intraoperative examining for bone continuity,5 cases were continuity and 30 cases were non-continuity.In the bone stability,13 cases were stability and 22 cases were non-stability.The study group was closer to intraoperative bone continuity and bone stability,and the differences of them between two groups were statistically significant(x2=12.857,4.644,P<0.05),respectively.Conclusion:The combination of digital X-ray radiography and SPECT radionuclide bone imaging has higher diagnostic value for intertrochanteric fracture of femur,which can provide important reference for clinical diagnosis.

Objective:To explore the epidemiology and clinical characteristics of hospitalized patients with acute poisoning at the First Affiliated Hospital of Nanchang University in Jiangxi Province.Methods:Based on the electronic medical records management platform of the First Affiliated Hospital of Nanchang University, a retrospective analysis was conducted on hospitalized patients with acute poisoning based on ICD-10 disease codes from 2014 to 2021. The gender, age, residence, poison type, etiology, route of exposure, illness severity, diagnostic and therapeutic processes, hospital stay duration, and prognosis of patients were collected.Results:A total of 1 953 cases of acute poisoning were included, comprising 871 males (44.6%) and 1 082 females (55.4%). The age was (42.7±20.0) years, with 113 fatalities (5.8%). Urban residents accounted for 706 cases (36.1%) and rural residents for 1 247 cases (63.9%). The highest incidence occurred in the 41-60 age group. Suicide was the primary cause, constituting 1 318 cases (67.5%), followed by accidental ingestion or contact, with overdose being less frequent. Oral poison way was the predominant route (1 681 cases, 86.1%), followed by inhalation and contact. Pesticide poisoning was the predominant type of poisoning in this study, with 847 cases (43.4%), followed by drug poisoning and foodborne poisoning. Pesticide poisoning predominated among rural residents (79.2%), while drug poisoning was more prevalent among urban residents (53.5%).Conclusions:In this study, patients with acute poisoning exhibited predominantly female gender, hailed from rural areas, and primary etiology of poisoning was pesticide ingestion for suicidal intent. Targeted education and control measures should be carried out for the above high-risk areas, populations and poisons.

Food-borne pathogens pose great risks to human health and public safety, and the formation of biofilm exacerbates their pathogenicity and antimicrobial resistance. Enzymes can target special substances in the biofilm to disintegrate the biofilm of food-borne pathogens, which has great potential for applications. This review summarized the progress of using enzymes to disintegrate the biofilms of food-borne pathogens, highlighting quorum-quenching enzymes, C-di-GMP metabolic enzymes, as well as extracellular matrix hydrolases. Finally, challenges and perspectives on developing enzymes into effective products for disintegrating the biofilms of food-borne pathogens were discussed.
Biofilms ; Humans ; Quorum Sensing

Objective To summary the clinical characteristics of epileptic spasm(ES)that is the unique form of seizures in childhood. Methods A total of 149 patients with ES who visited our hospital from May 2009 to June 2015 were collected. The documents of clinical data, treatment and outcome were analyzed retrospectively. The statistical analysis of some clinical characteristics and prognosis of patients were performed. Results There were 97(65.1%) male and 52 (34.9%) female in the 149 patients. The onset age of ES was from 30 days to 42 months (median value was 6 months) including 17 patients more than 12 months.The peak age of onset was 4-7 months. One hundred and forty-seven patients manifested clustered spasm. One pair of twins showed single spasm.Other types of seizure were seen before ES onset in 13 (8.7%) patients, and after ES onset in 42 (28.2%) patients.Eighty-three patients (55.7%) were diagnosed as West syndrome (WS). There were 46 patients (30.9%) with cryptogenic cause, 103 patients (69.1%) diagnosed with symptomatic epilepsy, in which 69 patients were with a clear cause. The proportions of developmental delay in the cryptogenic and symptomatic patients were 74.5% and 92.2% after the onset of the ES. The degree of developmental delay was linearly related to the course of ES. The hyperarrhythmia of electroencephalogram (EEG) background was seen in 122 patients (81.9%), and there was no significant difference in hyperarrhythmia between different etiology groups or different onset age groups. The short-term efficiency of topiramate evaluated within one month was 30.5% in 59 newly diagnosed patients. The short-term effective rate of adrenocorticotropic hormone (ACTH) was 80.3% in total 76 patients, but single ACTH treatment was associated with an increased recurrent rate. Conclusion ES is a highly age dependent seizure type that mainly found in WS,which typically follows a EEG hyperarrhythmia and developmental delay. The treatment of ES is difficult. ACTH combined with effective antiepileptic drugs (AEDS) is currently the most reasonable drug treatment program.

To facilitate noninvasive diagnosis of anemia, high-performance and portable near infrared (NIR) spectrometer for human blood constituents was designed and fabricated based on linear variable filter (LVF).Meanwhile, the performance of support vector regression (SVR) model for quantitative analysis of human hemoglobin (Hb) was investigated.Spectral data were collected noninvasively from 100 volunteers by self-designed LVF-NIR spectrometer, then divided into calibration set, validation set 1 and 2.To establish a robust SVR model, grid search method was applied to optimize the penalty parameter and kernel function parameter c=5.28, g=0.33.Then, Hb levels in the validation 1 and 2 sets were quantitatively analyzed.The results showed that the root mean square error of prediction (RMSEP) were 10.20 g/L and 10.85 g/L, respectively, and the relative RMSEP (R-RMSEP) were 6.85% and 7.48%, respectively.The results indicated that the SVR model had high prediction accuracy to Hb level and adaptability to different samples, and could satisfy the requirements of clinical measurement.Based on the SVR algorithm, the self-designed LVF-NIR spectrometer has a wide application prospect in the field of non-invasive anemia diagnosis.

Objective To investigate the clinical efficacy of complete mesogaster excision in the radical gastrectomy for gastric cancer.Methods The clinical data of 100 patients with distal gastric cancer who were admitted to the First Affiliated Hospital of Harbin Medical University from January 2011 to December 2012 were retrospectively analyzed.All the patients underwent complete mesogaster excision in D2 radical gastrectomy for gastric cancer.The operation quality was evaluated according to operation time,volume of intraoperative blood loss,mean number of lymph nodes dissected,time to flatus,volume of drainage and duration of postoperative hospital stay.Patients were followed up by outpatient examination and telephone interview till May 2014.Results Complete mesogaster excision in the radical gastrectomy for gastric cancer was successfully carried out on all the 100 patients.The operation time,volume of intraoperative blood loss,mean number of lymph nodes dissected,time to flatus,volume of drainage and duration of postoperative hospital stay were (118 ± 34) minutes (range,90-160 minutes),(80±25)mL (range,45-135 mL),38± 10 (range,25-52),(3.0 ± 1.2)days (range,1.5-4.5 days),(62±15)mL (range,15-85 mL) and (7.0±1.5)days (range,4.0-11.5 days),respectively.According to the postoperative pathological results,there were 36 patients with high differentiated gastric carcinoma,38 with moderate and/or low differentiated gastric carcinoma,17 with low differentiated gastric carcinoma and 9 with signet ring cell carcinoma.After operation,3 patients had gastroplegia,2 with poor healing of abdominal incision,2 with duodenal stump fistula,1 with pancreatic fistula,and all of them were cured by conservative treatment.All the 100 patients were followed up for a mean time of 25.6 months (range,17.6-39.2 months).There was no tumor recurrence.Conclusions Complete mesogaster excision in the radical gastrectomy for gastric cancer is safe and feasible,with the advantage of minimal trauma,low morbidity and quick recovery during the follow up.

Objective:To analyze the incidence trend, current status and survival period of young patients with lung cancer aged from 15 to 44 years in Shanghai between 2002 to 2005. Methods:All the data were collected from the database of registration and ma-nagement system of diagnosed cancer cases in Shanghai city organized by Shanghai Municipal Center for Disease Control & Prevention. The incidence trend was analyzed by using APC(annual percent change)model. The survival period and median survival time were calculated by using SPSS 12.0 software and life table method. The univariate and multivariate analyses were analyzed by using Kaplan-Meier and COX regression model, respectively.Results:A total of 972 young patients with lung cancer who aged from 15 to 44 years were diagnosed in Shanghai between 2002 and 2005, accounting for 3.09% of the whole percentage of adenocarcinoma in young patients was higher than that in whole lung cancer population at the same period, while the TNM stage was not significantly different between male and female young patients. Multivariate analysis demonstrated that gender, pathological classification and TNM stage were independent prognostic factors for young patients with lung cancer. Conclusion:The lung cancer had different characteristics in young patients compared with that in whole lung cancer population in Shanghai city. It was necessary to further investigate the biologic behavior of lung cancer in young patients.