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.

ObjectiveTo establish a geographical origin identification model for Foeniculi Fructus from Haiyuan， providing a new technical reference for the protection of Haiyuan's geo-authentic medicinal materials and its designation as a national geographical indication agricultural product. MethodsSamples of Foeniculi Fructus were collected from eight producing areas， including Minqin （Gansu）， Bozhou （Anhui）， Qingdao （Shandong）， Dezhou （Shandong）， Urumqi （Xinjiang）， Nujiang （Yunnan）， Gutuo （Inner Mongolia）， and Haiyuan （Ningxia）. Gas chromatography-ion mobility spectrometry （GC-IMS） was used to detect the volatile organic compounds （VOCs） in samples from these geographic origins. VOCs were qualitatively analyzed through dual matching with the National Institute of Standards and Technology （NIST） mass spectral database and the IMS drift time database. Using the Reporter module and Gallery Plot visualization tools within the LAV analytical platform， VOC fingerprint profiles characterizing geographic origins were constructed. A non-targeted analytical strategy was adopted， and 97 VOCs detected via GC-IMS were subjected to principal component analysis （PCA） and partial least squares discriminant analysis （PLS-DA） based on their differential distribution patterns to construct an origin identification model for Foeniculi Fructus from Haiyuan region. Key discriminative markers were screened using variable importance in projection （VIP） values greater than 1. ResultsA total of 97 VOCs were identified， including alcohols， aldehydes， ketones， esters， organic acids， terpenoids， ethers， alkenes， and benzenes. The PLS-DA model， based on VOCs data obtained by GC-IMS， effectively distinguished Foeniculi Fructus in Haiyuan region from those of other origins. During cross-validation， the model achieved a prediction parameter （Q²） of 0.976 and a goodness-of-fit parameter （R²） of 0.936， with no overfitting observed in permutation testing. Twelve key flavor markers with VIP > 1 were identified as characteristic indicators of Haiyuan origin. ConclusionA stable and highly predictive origin identification model for Foeniculi Fructus from Haiyuan was successfully established using GC-IMS technology， PLS-DA， and VIP-based marker screening. This model provides a novel technical strategy for accurately distinguishing Foeniculi Fructus in Haiyuan region from other regional varieties and offers new technical support for its protection as a geo-authentic medicinal material and a nationally designated geographical indication agricultural product in China.

ObjectiveTo establish a geographical origin identification model for Foeniculi Fructus from Haiyuan， providing a new technical reference for the protection of Haiyuan's geo-authentic medicinal materials and its designation as a national geographical indication agricultural product. MethodsSamples of Foeniculi Fructus were collected from eight producing areas， including Minqin （Gansu）， Bozhou （Anhui）， Qingdao （Shandong）， Dezhou （Shandong）， Urumqi （Xinjiang）， Nujiang （Yunnan）， Gutuo （Inner Mongolia）， and Haiyuan （Ningxia）. Gas chromatography-ion mobility spectrometry （GC-IMS） was used to detect the volatile organic compounds （VOCs） in samples from these geographic origins. VOCs were qualitatively analyzed through dual matching with the National Institute of Standards and Technology （NIST） mass spectral database and the IMS drift time database. Using the Reporter module and Gallery Plot visualization tools within the LAV analytical platform， VOC fingerprint profiles characterizing geographic origins were constructed. A non-targeted analytical strategy was adopted， and 97 VOCs detected via GC-IMS were subjected to principal component analysis （PCA） and partial least squares discriminant analysis （PLS-DA） based on their differential distribution patterns to construct an origin identification model for Foeniculi Fructus from Haiyuan region. Key discriminative markers were screened using variable importance in projection （VIP） values greater than 1. ResultsA total of 97 VOCs were identified， including alcohols， aldehydes， ketones， esters， organic acids， terpenoids， ethers， alkenes， and benzenes. The PLS-DA model， based on VOCs data obtained by GC-IMS， effectively distinguished Foeniculi Fructus in Haiyuan region from those of other origins. During cross-validation， the model achieved a prediction parameter （Q²） of 0.976 and a goodness-of-fit parameter （R²） of 0.936， with no overfitting observed in permutation testing. Twelve key flavor markers with VIP > 1 were identified as characteristic indicators of Haiyuan origin. ConclusionA stable and highly predictive origin identification model for Foeniculi Fructus from Haiyuan was successfully established using GC-IMS technology， PLS-DA， and VIP-based marker screening. This model provides a novel technical strategy for accurately distinguishing Foeniculi Fructus in Haiyuan region from other regional varieties and offers new technical support for its protection as a geo-authentic medicinal material and a nationally designated geographical indication agricultural product in China.

Objective: To assess the impact of long-term antiretroviral therapy (ART) on human immunodeficiency virus (HIV) blood screening outcomes in post-exposure prophylaxis (PEP) failure cases through a longitudinal analysis of blood screening results over a 7-year period in a patient with HIV PEP failure. Methods: This study conducted 13 follow-up assessments for a high-risk individual who initiated ART shortly after exposure. The effectiveness of various blood screening methods, including immunological assays and nucleic acid testing (NAT), was analyzed. Blood samples were also tested with HIV RNA quantification testing, Western blot (WB) confirmation testing, chemiluminescence immunoassay (CLIA), and HIV rapid tests utilizing gold and selenium labels. A comprehensive analysis was performed to evaluate the changes in diagnostic capabilities of different testing methods for HIV biomarkers over an extended period following PEP failure. Results: The patient had two high-risk exposures: one day before ART initiation (BA1) and seven days preceding treatment (BA7). On the first day after the ART treatment (AA1), the HIV RNA concentration (viral load) was 9.07×10 copies/mL; by day five (AA5), the viral load decreased to 1.04×10 copies/mL. At day eleven (AA11), NAT and ELISA tests were both positive, with the WB result remaining indeterminate (gp160+). At day 48 (AA48), the S/CO value of the fourth generation ELISA reagent was 1.07, while results from a 6-sample pool and quantitative NAT were negative. However, a single sample NAT returned a positive result and WB tests indicated positivity for p17, p24, and gp160. At AA74, the quantitative NAT rebounded to 2.83×10 copies/mL, with positive NAT results for single and 6-sample pool NAT tests. The S/CO values of the imported and domestic ELISA reagents were 3.39 and 23.44, respectively. At AA201, 6-sample pool and quantitative NAT were negative again, while single sample NAT remained positive. From AA319 to AA2221, all NAT results have remained consistently below the minimum detection limit. At AA2221, S/CO values of the imported and domestic ELISA reagents were 3.47 and 23.44, respectively. Conclusion: The findings indicate that patients experiencing PEP failure after high-risk HIV exposure are at a higher risk of being missed by mixed-sample NAT pools and individual serological tests. Nonetheless, anti-HIV antibody levels are sustained at elevated values for an extended duration, underscoring antibody testing as an effective measure for blood screening.

Humans ; Asthma/drug therapy* ; Biological Therapy

OBJECTIVE To evaluate the quality of Prunella vulgaris by entropy weight method combined with grey correlation degree analysis method by determining the contents of rosmarinic acid， total flavonoids， water and water-soluble extract. METHODS The content of rosmarinic acid was determined by HPLC； the content of total flavonoids was determined by UV spectrophotometry； the contents of water and water-soluble extract were determined according to the general rules of Chinese Pharmacopoeia （part Ⅳ）. The weight coefficients of four indexes as rosmarinic acid were calculated by entropy weight method， and the relative correlation degree of each index was analyzed by grey correlation degree analysis method， and the quality of 117 batches of P. vulgaris was ranked. RESULTS The contents of rosmarinic acid， total flavonoids， water and water-soluble extractive were 0.237 1%-0.943 0%， 2.923 6%-6.400 7%， 8.736 7%-12.446 3%， 11.638 8%-19.166 2%， respectively. The weight coefficients were 0.297 1， 0.277 5， 0.163 7 and 0.261 6， respectively. The relative correlation degrees were 0.159 3-0.616 3， and the correlation degree of S24 batch of samples was the highest （0.616 3）； that of P. vulgaris from Nanjing of Jiangsu Province ranged from 0.500 9 to 0.616 3， ranking the first. CONCLUSIONS Using the contents of rosmarinic acid， total flavonoids， water and water-soluble extract as indexes， entropy weight method and grey correlation degree analysis method can be used to evaluate the quality of P. vulgaris. The quality of different batches of P. vulgaris are different， and the quality of P. vulgaris produced in Nanjing of Jiangsu Province is the best.

Coronavirus disease 2019 (COVID-19) can cause great damage to the elderly patients and lead to high mortality. The clinical presentations and auxiliary examinations of the elderly patients with COVID-19 are atypical, due to the physiological ageing deterioration and basal pathological state. The treatment strategy for the elderly patients has its own characteristics and treatment protocol should be considered accordingly. To improve the diagnosis, treatment, and prevention of COVID-19 in the elderly, the Expert Committee of Geriatric Respiratory and Critical Care Medicine, China Society of Geriatrics established the "Expert consensus for the diagnosis, treatment, and prevention of coronavirus disease 2019 in the elderly" . We focused on the clinical characteristics and key points for better treatment and prevention of COVID-19 in the elderly. (1) For diagnosis, atypical clinical presentation of COVID-19 in the elderly should be emphasized, which may be complicated by underlying disease. (2) For treatment, strategy of multiple disciplinary team (mainly the respiratory and critical care medicine) should be adopted and multiple systemic functions should be considered. (3) For prevention, health care model about integrated management of acute and chronic diseases, in and out of hospital should be applied.

Objective By using CT-guided percutaneous inoculation with "external pre-loaded and traced one-step implantation technique" to establish VX2 liver and kidney tumor model in experimental rabbits, and to evaluate the effectiveness and convenience of this technique. Methods By using a disposal 16G thoracic puncture needle (length of 8. 5 cm) and a self-made 18 G puncture probe, inoculation of tumor cells was performed in experimental rabbits. Retrograde filling of gelatin sponge strip, which was infiltrated with 0. 3 mL contrast medium, into the thoracic puncture needle lumen was performed, which was followed by retrograde loading of 1X1X3 mm3 VX2 tissue block, and the pre-assembly in vitro was completed. Under CT guidance, percutaneous puncturing of the target organ of experimental rabbit with pre - assembly probe was conducted, then, the end of the needle was inserted into the probe to push out the tumor tissue and gelatin sponge when it was verified that the needle tip reached the desired target point. After 30 seconds, the needle and probe were pulled out slowly and integrally, and the puncture point was manually pressed for 60 seconds. CT scan was performed to check the location of high-density gelatin sponge. The tumor inoculation time was recorded. Contrast - enhanced CT scan was employed at 2, 3 and 4 weeks after inoculation to validate the modeling results. Results Immediate postoperative CT scan showed that the inoculation site was manifested as nodular high density shadow in the liver or kidney parenchyma. Liver tumor modeling was used in 10 rabbits, and tumor formation was obtained in all 10 rabbits (100％, 10/10), and the mean time used for inoculation was 4. 3 minutes. Kidney tumor modeling was adopted in 10 rabbits, and tumor formation was obtained in 9 rabbits (90％, 9/10), and the mean time used for inoculation was 4. 9 minutes. The inoculated tumor was characterized by a single lesion in all experimental rabbits, the location of the tumor was basically the same as that of the high density gelatin sponge. Check-up contrast-enhanced CT scan showed that the liver implanted tumor had peripheral enhancement, which presented as ring - shaped enhancement on DSA. The kidney implanted tumor was manifested as renal parenchyma staining defect on both contrast - enhanced CT scan and DSA. After 3-4 weeks of inoculation, the implanted tumors grew rapidly. Conclusion For the establishment of rabbit VX2 liver and kidney tumor models, CT - guided percutaneous inoculation with "external pre-loaded and traced one-step implantation technique" is very effective. This technique has several advantages, such as convenient and time-saving, postoperative immediate confirmation of the inoculation site, higher tumor formation rate, solitary tumor formation, etc. (J Intervent Radiol, 2018, 27:252-256)

Precision medicine for cancer patients aims to adopt the most suitable treatment options during diagnosis and treatment of individuals.Detecting circulating tumor cell (CTC) or circulating tumor DNA (ctDNA) in plasma or serum could serve as liquid biopsy,which would be useful for numerous diagnostic applications.Liquid biopsies can help clinicians screen and detect cancer early,stratify patients to the most suitable treatment and real-time monitoring of treatment response and resistance mechanisms in the tumor,evaluate the risk for metastatic relapse,and estimate prognosis.We summarized the advantages and disadvantages of tissue and liquid biopsies.We also further compared and analyzed the advantages and limitations of detecting CTCs,ctDNAs,and exosomes.Furthermore,we reviewed the literature related with the application of serum or plasma CTCs,ctDNAs,and exosomes for diagnosis and prognosis of cancer.We also analyzed their opportunities and challenges as future biomarkers.In the future,liquid biopsies could be used to guide cancer treatment.They could also provide the ideal scheme to personalize treatment in precision medicine.

Objective To explore the MRI features about the annular ligament injuries in pediatric patients. Methods The appearance of MRI about annular ligament injuries in 15 pediatric patients diagnosed clinically were retrospectively analyzed. All patients (aged 4 years 8 months to 12 years 11 months) were scanned by MRI in 2-4 days after injury. Patients were divided into three groups according to the annular ligament injuries severity, which were simple annular ligament injuries, annular ligament injuries combined dislocation, annular ligament ruptures combined dislocation. Results Simple annular ligament injuries were showed in 2 cases, which appeared high signal but continuous configuration. Annular ligament injuries combined dislocation were showed 9 cases. Bald head sign, thickening and continuous ligment were found on axial image, together with compression of the radial joint space on sagittal and coronal view. Annular ligament ruptures combined dislocation were showed in 4 cases. The ligment showed"bald head sign", tortuosity and uneven thickening on axial view and compression of the radial joint space on sagittal and coronal view. Combining with the other tissue injuries were detected in 15 cases. Conclusion The annular ligament injuries show some MRI characteristics. Bald head sign is specific in the annular ligament injuries of pediatric patients.