Traumatic main bronchus rupture is a relatively rare injury in thoracic trauma, which is extremely critical, with a mortality rate as high as 70% - 80%. The complete rupture and displacement of the traumatic cervical trachea can lead to asphyxia, hypoxia, and cardiac arrest, even death of the patient in a short time. We performed emergency surgery with the support of extracorporeal membrane oxygenation for a case of traumatic cervical tracheal trunk complete rupture and displacement combined with cardiac arrest and achieved a successful rescue. We summarized our experience and found that timely surgical reconstruction of the airway is the key to increasing the traumatic main bronchus rupture survival of patients.
Humans ; Extracorporeal Membrane Oxygenation ; Heart Arrest/etiology* ; Rupture ; Trachea/surgery*

Objective To investigate the role of CISD1 in gefitinib-resistant non-small cell lung cancer(NSCLC),so as to provide a potential therapeutic target for the treatment of gefitinib-resistant NSCLC.Methods Bioinformatics online platforms TIMER2.0 and HPA were used to analyze the expression level of CISD1 in lung cancer.TIMER2.0 and GEPIA2.0 were used to analyze the correlation between the expression levels of CISD1 and SLC7A11 in lung cancer.The correlation between CISD1 and overall survival rate of lung cancer patients was analyzed using KMPLOT.Human lung carcinoma cell line PC9 and gefitinib-resistant cell line PC9/GR were treated with gefitinib,and cell viability was detected using the CCK8 method.shCISD1 lentivirus infection was used to knockdown CISD1 in PC9/GR cells.Western blotting was employed to detect the protein expression levels of CISD1 and SLC7A11.PC9/GR cells were divided into shNC+DMSO group,shNC+gefitinib group,shCISD1 group,shCISD1+ferrostatin-1 group,and shCISD1+gefitinib group.Plate clone formation assay was used to detect cell proliferation capacity.FerroOrange fluorescent probe and C11-BODIPY fluorescent probe were used to detect intracellular free Fe2+content and intracellular lipid peroxide level,respectively.Results CISD1 was significantly overexpressed in lung carcinoma(P＜0.001).The expression level of CISD1 was negatively correlated with the overall survival rate of lung cancer patients and negatively correlated with the expression level of SLC7A11.Compared with the DMSO control group,gefitinib treatment significantly reduced clone formation and CISD1 protein expression levels in both PC9 and PC9/GR cells(P＜0.05),but the reduction was less pronounced in PC9/GR cells.shCISD1 infection significantly inhibited the protein expression levels of CISD1 and SLC7A11 in PC9/GR cells(P＜0.05)and enhanced the sensitivity of PC9/GR cells to gefitinib.Compared with the shNC+DMSO group,both the shNC+gefitinib group and the shCISD1 group showed significantly reduced clone formation ability(P＜0.05),but increased Fe2+and lipid peroxidation levels(P＜0.05).Compared with the shCISD1 group,the shCISD1+ferrostatin-1 group showed significantly increased clone formation ability(P＜0.05),but decreased Fe2+and lipid peroxidation levels(P＜0.05).Compared with the shNC+gefitinib group,the shCISD1+gefitinib group showed significantly reduced clone formation ability(P＜0.05),but increased Fe2+and lipid peroxidation levels(P＜0.05).Conclusion Knockdown of CISD1 promotes the sensitivity of NSCLC to gefitinib by inducing ferroptosis,which provides a new potential therapeutic target for the treatment of gefitinib-resistant NSCLC.

Abstract Upper cross syndrome (UCS) is an abnormal body posture phenomenon. The detection rate of UCS in adolescents is high in China, which has become a serious public health problem threatening the health of adolescents. Exercise therapy has a positive effect on the prevention and treatment of UCS.The article reviews the pathological mechanisms of muscle imbalance, muscle interaction inhibition, and neural control related to the occurrence and development of UCS both domestically and internationally in recent years.And it elucidates the effects and corresponding mechanisms of exercise interventions such as gentle exercise, stretching exercise and physical function training on UCS, so as to provide help for the correction of UCS.

Objective: To explore the potential classification of 24 hour activity time allocation among college students in Yinchuan and its association with active health levels, so as to provide references for optimizing activity time allocation to enhance active health levels. Methods: From November 18 to December 6, 2024, a stratified cluster random sampling method was used to select 2 422 first and second year college students from full time undergraduate institutions in Yinchuan. The Chinese College Students 24 hour Movement Behaviors Questionnaire (24 h MBQ) and Active Health Behavior Scale were used to assess 24 hour activity time allocation and evaluate active health levels. Latent profile analysis (LPA) was employed to categorize activity types, and a binary Logistic regression analysis was conducted to analyze the relationship between active health levels and activity types. Results: A total of 1 087 students (44.9%) were found of meeting active health standards, and significant statistical differences were found in active health levels across different genders, grades, academic qualities, sources of origin and academic categories ( χ 2= 22.03 , 7.65, 25.50, 10.12, 43.44, all P <0.01). Moreover, significant statistical differences could also be found among college students 24 hour activity time across different genders, ages, grades, sources of origin, academic qualities, and academic categories ( t/Z/H/F=-5.70-111.39, P <0.05).The 24 hour activity time allocation was classified into four types:academic high ( 6.9 %), low activity rest (8.8%), light activity (67.8%), and high activity dynamic (16.4%). Significant statistical differences were observed in activity time allocation categories across different ages, academic qualities and academic categories ( χ 2=15.52-108.46, all P <0.05). Using the high activity dynamic type as a reference, the light activity type ( OR=0.39, 95%CI =0.31-0.50), low activity rest type ( OR=0.10, 95%CI =0.06-0.15), and academic high type ( OR=0.03, 95%CI =0.02-0.07) had lower active health levels among college students (all P <0.01). Conclusion There is a significant difference in 24 hour activity time allocation among college students in Yinchuan, and different activity types are associated with active health levels.

Objective To investigate the role of CISD1 in gefitinib-resistant non-small cell lung cancer(NSCLC),so as to provide a potential therapeutic target for the treatment of gefitinib-resistant NSCLC.Methods Bioinformatics online platforms TIMER2.0 and HPA were used to analyze the expression level of CISD1 in lung cancer.TIMER2.0 and GEPIA2.0 were used to analyze the correlation between the expression levels of CISD1 and SLC7A11 in lung cancer.The correlation between CISD1 and overall survival rate of lung cancer patients was analyzed using KMPLOT.Human lung carcinoma cell line PC9 and gefitinib-resistant cell line PC9/GR were treated with gefitinib,and cell viability was detected using the CCK8 method.shCISD1 lentivirus infection was used to knockdown CISD1 in PC9/GR cells.Western blotting was employed to detect the protein expression levels of CISD1 and SLC7A11.PC9/GR cells were divided into shNC+DMSO group,shNC+gefitinib group,shCISD1 group,shCISD1+ferrostatin-1 group,and shCISD1+gefitinib group.Plate clone formation assay was used to detect cell proliferation capacity.FerroOrange fluorescent probe and C11-BODIPY fluorescent probe were used to detect intracellular free Fe2+content and intracellular lipid peroxide level,respectively.Results CISD1 was significantly overexpressed in lung carcinoma(P＜0.001).The expression level of CISD1 was negatively correlated with the overall survival rate of lung cancer patients and negatively correlated with the expression level of SLC7A11.Compared with the DMSO control group,gefitinib treatment significantly reduced clone formation and CISD1 protein expression levels in both PC9 and PC9/GR cells(P＜0.05),but the reduction was less pronounced in PC9/GR cells.shCISD1 infection significantly inhibited the protein expression levels of CISD1 and SLC7A11 in PC9/GR cells(P＜0.05)and enhanced the sensitivity of PC9/GR cells to gefitinib.Compared with the shNC+DMSO group,both the shNC+gefitinib group and the shCISD1 group showed significantly reduced clone formation ability(P＜0.05),but increased Fe2+and lipid peroxidation levels(P＜0.05).Compared with the shCISD1 group,the shCISD1+ferrostatin-1 group showed significantly increased clone formation ability(P＜0.05),but decreased Fe2+and lipid peroxidation levels(P＜0.05).Compared with the shNC+gefitinib group,the shCISD1+gefitinib group showed significantly reduced clone formation ability(P＜0.05),but increased Fe2+and lipid peroxidation levels(P＜0.05).Conclusion Knockdown of CISD1 promotes the sensitivity of NSCLC to gefitinib by inducing ferroptosis,which provides a new potential therapeutic target for the treatment of gefitinib-resistant NSCLC.

Objective:To investigate the association between serum thyroid-stimulating hormone(TSH) level and the 10-year risk of atherosclerotic cardiovascular disease(ASCVD) in men over 50 years old with type 2 diabetes mellitus(T2DM).Methods:This study included male T2DM patients aged≥50 years, diagnosed at the First Hospital of Lanzhou University between July 2021 and March 2022. Patients were categorized into three groups based on serum TSH level: elevated TSH group(T3, TSH>5.91 mIU/L) and normal TSH group, which was further divided into T1(0.56 mIU/L≤TSH<3.24 mIU/L) and T2(3.24 mIU/L≤TSH≤5.91 mIU/L) group. The 10-year ASCVD risk index was compared across groups. Spearman correlation and multiple linear regression analyses were used to assess the independent association between TSH level and 10-year ASCVD risk index. Results:A total of 490 male T2DM patients aged≥50 years were included(T1: 310, T2: 131, T3: 49). The 10-year ASCVD risk index was significantly higher in T3 group than that in T1 group(18.40% vs 13.90%, χ2=9.47, P<0.05). Serum TSH level showed a positive correlation with the 10-year ASCVD risk( r=0.144, P<0.05). After adjusting for confounders such as age, hypertension, lipid profile, diabetes duration, aspartate aminotransferase, albumin, lactate dehydrogenase, estimated glomerular filtration rate, creatinine, and phosphorus, multiple linear regression confirmed that TSH level was independently associated with the 10-year ASCVD risk index( β=0.23, 95% CI 0.02-0.45). Conclusions:Higher serum TSH level is independently associated with an increased 10-year ASCVD risk in men over 50 years old with T2DM. Regular TSH monitoring may aid in cardiovascular risk stratification in this population.

Objective To explore the preventive value of electroacupuncture combined with antithrombotic compression banding for deep venous thrombosis(DVT)in high-risk patients with neurocritical venous thromboembolism(VTE).Methods A total of 98 high-risk patients with neurocritical VTE who were admitted to the First Hospital of Jiaxing from April 2023 to May 2024 were selected as research subjects.They were divided into pressure band group and electroacupuncture group by random number table method,with 49 cases in each group.Both groups of patients were given low molecular weight heparin to prevent thrombosis.The pressure band group was given antithrombotic compression banding intervention,and electroacupuncture group was combined with electroacupuncture intervention on the basis of antithrombotic compression banding.Both groups were treated continuously for 14 days.The changes in levels of D-dimer(D-D),interleukin-6(IL-6),fibrinogen(FIB),intercellular adhesion molecule-1(ICAM-1),activated partial thromboplastin(APTT),tumor necrosis factor-α(TNF-α),prothrombin time(PT)and the scores of activity of daily living(ADL)scale of two groups of patients before treatment and after 7 days and 14 days of treatment were compared.The incidences of VTE,tenderness and superficial varicose veins of two groups of patients were statistically analyzed.Results After 7 days and 14 days of treatment,the levels of D-D,FIB,IL-6,ICAM-1,and TNF-α in both groups were significantly lower than those before treatment,APTT and PT were significantly longer than those before treatment,and ADL scores were significantly higher than those before treatment(P＜0.05).After 7 days and 14 days of treatment,the levels of D-D,FIB,IL-6,ICAM-1 and TNF-α in electroacupuncture group were significantly lower than those in pressure band group,and ADL score was significantly higher than that in pressure band group(P＜0.05).The APTT and PT of patients in electroacupuncture group after 7 days of treatment were significantly longer than those in pressure band group(P＜0.05).The incidences of VTE,tenderness and superficial varicose veins in electroacupuncture group were significantly lower than those in pressure band group(P＜0.05).Conclusion The application of electroacupuncture combined with antithrombotic compression banding in neurocritical VTE high-risk patients can alleviate inflammatory responses,improve coagulation function,and reduce the occurrence of VTE,tenderness,and superficial varicose veins.

Objective:To investigate the association between serum thyroid-stimulating hormone(TSH) level and the 10-year risk of atherosclerotic cardiovascular disease(ASCVD) in men over 50 years old with type 2 diabetes mellitus(T2DM).Methods:This study included male T2DM patients aged≥50 years, diagnosed at the First Hospital of Lanzhou University between July 2021 and March 2022. Patients were categorized into three groups based on serum TSH level: elevated TSH group(T3, TSH>5.91 mIU/L) and normal TSH group, which was further divided into T1(0.56 mIU/L≤TSH<3.24 mIU/L) and T2(3.24 mIU/L≤TSH≤5.91 mIU/L) group. The 10-year ASCVD risk index was compared across groups. Spearman correlation and multiple linear regression analyses were used to assess the independent association between TSH level and 10-year ASCVD risk index. Results:A total of 490 male T2DM patients aged≥50 years were included(T1: 310, T2: 131, T3: 49). The 10-year ASCVD risk index was significantly higher in T3 group than that in T1 group(18.40% vs 13.90%, χ2=9.47, P<0.05). Serum TSH level showed a positive correlation with the 10-year ASCVD risk( r=0.144, P<0.05). After adjusting for confounders such as age, hypertension, lipid profile, diabetes duration, aspartate aminotransferase, albumin, lactate dehydrogenase, estimated glomerular filtration rate, creatinine, and phosphorus, multiple linear regression confirmed that TSH level was independently associated with the 10-year ASCVD risk index( β=0.23, 95% CI 0.02-0.45). Conclusions:Higher serum TSH level is independently associated with an increased 10-year ASCVD risk in men over 50 years old with T2DM. Regular TSH monitoring may aid in cardiovascular risk stratification in this population.

Objective To explore the preventive value of electroacupuncture combined with antithrombotic compression banding for deep venous thrombosis(DVT)in high-risk patients with neurocritical venous thromboembolism(VTE).Methods A total of 98 high-risk patients with neurocritical VTE who were admitted to the First Hospital of Jiaxing from April 2023 to May 2024 were selected as research subjects.They were divided into pressure band group and electroacupuncture group by random number table method,with 49 cases in each group.Both groups of patients were given low molecular weight heparin to prevent thrombosis.The pressure band group was given antithrombotic compression banding intervention,and electroacupuncture group was combined with electroacupuncture intervention on the basis of antithrombotic compression banding.Both groups were treated continuously for 14 days.The changes in levels of D-dimer(D-D),interleukin-6(IL-6),fibrinogen(FIB),intercellular adhesion molecule-1(ICAM-1),activated partial thromboplastin(APTT),tumor necrosis factor-α(TNF-α),prothrombin time(PT)and the scores of activity of daily living(ADL)scale of two groups of patients before treatment and after 7 days and 14 days of treatment were compared.The incidences of VTE,tenderness and superficial varicose veins of two groups of patients were statistically analyzed.Results After 7 days and 14 days of treatment,the levels of D-D,FIB,IL-6,ICAM-1,and TNF-α in both groups were significantly lower than those before treatment,APTT and PT were significantly longer than those before treatment,and ADL scores were significantly higher than those before treatment(P＜0.05).After 7 days and 14 days of treatment,the levels of D-D,FIB,IL-6,ICAM-1 and TNF-α in electroacupuncture group were significantly lower than those in pressure band group,and ADL score was significantly higher than that in pressure band group(P＜0.05).The APTT and PT of patients in electroacupuncture group after 7 days of treatment were significantly longer than those in pressure band group(P＜0.05).The incidences of VTE,tenderness and superficial varicose veins in electroacupuncture group were significantly lower than those in pressure band group(P＜0.05).Conclusion The application of electroacupuncture combined with antithrombotic compression banding in neurocritical VTE high-risk patients can alleviate inflammatory responses,improve coagulation function,and reduce the occurrence of VTE,tenderness,and superficial varicose veins.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.