Objective To investigate the perioperative differences between video-assisted thoracoscopic surgery (VATS) and thoracotomy after neoadjuvant therapy in patients with non-small cell lung cancer (NSCLC). Methods Clinical data of NSCLC patients who underwent VATS or thoracotomy after neoadjuvant therapy at Shanghai Pulmonary Hospital from June 2020 to May 2022 were retrospectively collected. Perioperative outcomes were compared between the two groups. Results A total of 260 patients were enrolled, 184 (70.8%) patients underwent VATS and 76 (29.2%) patients underwent thoracotomy. After propensity matching, there were 113 (62.4%) patients in the VATS group and 68 (37.6%) patients in the thoracotomy group. VATS had similar lymph node dissection ability and postoperative complication rate with thoracotomy (P>0.05), with the advantage of having shorter operative time (146.00 min vs. 165.00 min, P=0.006), less intraoperative blood loss (50.00 mL vs. 100.00 mL, P<0.001), lower intraoperative blood transfusion rate (0.0% vs. 7.4%, P=0.003), less 3-day postoperative drainage (250.00 mL vs. 350.00 mL, P=0.011; 180.00 mL vs. 250.00 mL, P=0.002; 150.00 mL vs. 235.00 mL, P<0.001), and shorter postoperative drainage time (9.34 d vs. 13.84 d, P<0.001) and postoperative hospitalization time (6.19 d vs. 7.94 d, P=0.006). Conclusion VATS after neoadjuvant therapy for NSCLC is safer than thoracotomy and results in better postoperative recovery.

ObjectiveMetabolomics was used to reveal the mechanism of Aconiti Lateralis Radix Praeparata（ALRP） in attenuating toxicity by processing from the aspects of amino acid metabolism， oxidative stress and energy metabolism by analyzing multiple metabolic pathways. MethodTwenty-four rats were randomly divided into control group， raw group and processed group， 8 rats in each group. The raw and processed group were given with 0.64 g·kg^-1 of raw ALRP and processed ALRP respectively every day， the control group was given with an equal amount of normal saline once a day. After continuous administration for 7 days， the urine， serum and heart tissue of rats were collected. Pathological examination of the heart was carried out using hematoxylin-eosin（HE） staining， and the activities of lactate dehydrogenase（LDH） and creatine kinase-MB（CK-MB） in serum and cardiac tissues were detected by microplate assay and immunoinhibition assay. The effects of ALRP on rat heart before and after processing were compared and analyzed. Ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS） was used to perform urine metabolomics analysis， and multivariate statistical analysis was used to screen for differential metabolites related to ALRP in attenuating toxicity by processing， and pathway enrichment analysis was carried out to explore the processing mechanism. ResultHE staining showed that no obvious pathological changes were observed in the heart tissue of the control group， while obvious infiltration of inflammatory cells such as plasma cells and granulocytes was observed in the heart tissue of the raw group， indicating that the raw ALRP had strong cardiotoxicity. There was no significant difference in HE staining of heart tissue between the processed group and the control group， indicating that the toxicity of ALRP was significantly reduced after processing. Compared with the control group， the activities of LDH and CK-MB were significantly increased in serum and heart tissue of the raw group， and those were significantly decreased in serum and heart tissue of the processed group， suggesting that the myocardial toxicity of processed ALRP was reduced. A total of 108 endogenous differential metabolites associated with the raw ALRP were screened using multivariate statistical analysis in positive and negative modes， of which 51 differential metabolites were back-regulated by the processed ALRP. Biological analysis of the key regulatory pathways and associated network changes showed that the pathways related to toxicity of ALRP mainly included tryptophan metabolism， arginine and proline metabolism， phenylalanine metabolism， aminoacyl-tRNA biosynthesis， alanine， aspartate and glutamate metabolism， etc. The metabolic pathways related to the attenuation of processed ALRP mainly included aminoacyl-tRNA biosynthesis， tryptophan metabolism， phenylalanine， tyrosine and tryptophan biosynthesis， phenylalanine metabolism and caffeine metabolism. ConclusionThe processing technology of ALRP in Guilingji can significantly attenuate the cardiotoxicity of raw products， the mechanism mainly involves amino acid metabolism， oxidative stress and energy metabolism， which can provide experimental bases for the research related to the mechanism of toxicity reduction of ALRP by processing and its clinical safety applications.

SWOT analysis is used to identify the strengths and external opportunities of scientific research management in hospitals.It facilitates the establishment of a systematic and rational approach to scientific research project management,help-ing hospitals to mitigate internal weaknesses and address external threats.This article chooses Y Hospital to carry out a case stud-y.SWOT analysis was done to investigate the hospital's strengths,weaknesses,opportunities,and threats.Based on the analysis results,it proposes targeted management strategies of"SO,""WO,""ST,"and"WT".After the use of the strategies in the management,the number of funded scientific research projects,published papers,registered invention patents,and achievements transferred from the scientific research remarkably increases,driving the improvement of research quality.

Objective:To analyze the epidemiological characteristics of hospitalized patients diagnosed with sepsis in a large class Ⅲ general hospital in Southwest China in a period of 2 years, and to explore the risk factors related to death in patients with sepsis.Methods:A retrospective study was conducted to select patients with sepsis admitted to Sichuan Provincial People's Hospital from September 1, 2021 to August 31, 2023, and general characteristics such as gender, age, discharge diagnosis, discharge department, hospitalization cost, length of stay, and prognosis during hospitalization were collected. The baseline of two groups of patients were compared, and the risk factors of in-hospital cause of death in patients with sepsis were analyzed by multivariate Logistic regression.Results:A total of 3 568 patients with sepsis were included with median age of 58 (35, 74) years old. Of all patients, there were 2 147 males (60.17%). The median length of hospitalization was 13 (8, 24) days, and the median hospitalization cost was 3.98 (1.87, 8.83) ten thousand yuan. The departments with more than 100 cases of sepsis in 2 years were central intensive care unit (ICU), pediatrics department, nephrology department, emergency medicine department, emergency intensive care unit (EICU), infectious department, respiratory medicine department, hematology department, neonatal care unit and emergency surgical department. A total of 1 210 patients (33.91%) admitted to ICU (including central ICU and EICU). The hospitalization cost of ICU patients were higher [6.7 (3.1, 15.5) ten thousand yuan], the hospitalization duration was longer [9 (3, 17) days], and the mortality was higher [35.29% (427/1 210)]. Among 3 568 patients with sepsis, 448 died and 3 120 survived during hospitalization. The age, male proportion and hospitalization cost of patients with sepsis in the death group were significantly higher than those in the survival group [age (years old): 75 (60, 86) vs. 57 (30, 71), male proportion: 67.86% (304/448) vs. 59.07% (1 843/3 120), hospitalization cost (ten thousand yuan): 6.7 (3.0, 16.9) vs. 3.7 (1.8, 8.1)], the ratio of diabetes mellitus was significantly lower than that of survival group [4.91% (22/448) vs. 10.45% (326/3 120)], the length of hospitalization was shorter than that of survival group [days: 10.0 (3.0, 19.0) vs. 13.0 (8.0, 24.0)], the differences were statistically significant (all P < 0.01). Multivariate Logistic regression analysis showed that male [odds ratio ( OR) = 0.75, 95% confidence interval (95% CI) was 0.59-0.96], elder ( OR = 1.04, 95% CI was 1.03-1.05) and diabetes ( OR = 0.32, 95% CI was 0.19-0.54) were independent risk factors for in-hospital death in patients with sepsis (all P < 0.05). Conclusions:Sepsis is a heavy burden in Southwest China, especially for ICU, with high mortality, high hospitalization costs, and heavy economic burden on patients and society. Male, elder and diabetes were independent risk factors for in-hospital death of sepsis patients.

Objective:To investigate the medication adherence and its influencing factors in young newly diagnosed pulmonary tuberculosis patients during different treatment periods, in order to provide a theoretical basis for formulating precise medication management strategies and thus improving the treatment success rate.Methods:A cross-sectional survey was conducted using a stratified random sampling method to select 283 young newly diagnosed pulmonary tuberculosis patients who visited and registered in the Kashgar region of Xinjiang from September 2021 to February 2022. The patients were divided into three groups according to the treatment time of receiving standard chemotherapy regimen: A (1-2 months of medication), B (3-4 months of medication), and C (5-6 months of medication), with 77, 89, and 117 cases, respectively. The clinical data of tuberculosis patients were collected by using the general information questionnaire,Eight-Item Morisky Medication Adherence Scale and Tuberculosis Medication Adherence Scale for tuberculosis patients.Results:Those who take medication well of three groups of young newly treated pulmonary tuberculosis patients were 93.5% (72/77), 89.9% (80/89), and 82.1% (96/117), respectively. The difference among the three groups was statistically significant ( χ2=6.23, P<0.05). Logistic regression analysis showed that social support was an influential factor for the 1st to 2nd month of medication ( OR=0.536, P<0.05); treatment confidence and psychological status were influential factors for the 3rd to 4th month of medication ( OR=0.668, 2.212, both P<0.05); comorbidity, social support, psychological status, and coping style were influential factors for the 5th to 6th month of medication ( OR values were 0.428 - 9.518, all P<0.05). Conclusions:The relevant factors that affect medication adherence vary among young newly diagnosed pulmonary tuberculosis patients at different stages of treatment. Accurate medication management strategies should be developed based on the influencing factors at each stage.

Objective:To understand the illness experience of patients with autologous liver transplantation and to lay the foundation for the formulation of targeted nursing measures.Methods:The objective sampling method was used to select the patients with autologous liver transplantation who were hospitalized in the hepatochydatid area of the First Affiliated Hospital of Xinjiang Medical University from September 2022 to March 2023 as the research objects. Based on the social ecosystem theory, the interview outline was formulated and semi-structured interview was conducted. After interviewing 15 people, the data was saturated. Colaizzi ′s 7-step phenomenological data analysis method was used to sort out and analyze the data. Results:There were three themes in body and mind experience of autologous liver transplantation patients: microsystem including changes in body function and mental state, meso-system including social adjustment and social dysfunction, macro system including limited access to care and lack of information support.Conclusions:The quality of life for patients improves after autologous liver transplantation compared to before surgery, but there are still issues within the social ecosystem. Medical staff should develop targeted nursing measures based on each patient ′s illness experience, improve their physical and mental functions and maintain stability in their social ecosystem.

Objective:To explore the mediating effect of medication self-efficacy between perceived social support and compliance behavior in young patients with newly treated pulmonary tuberculosis under the Southern Xinjiang Model.Methods:A cross-sectional survey was conducted in Kashgar Tuberculosis Prevention and Control Institute Hospital and Tuberculosis Specialist Hospital of Hetian from January 2022 to April 2023. A total of 302 young patients with initial treatment of pulmonary tuberculosis in were selected as the research objects by convenience sampling method. The General Information Questionnaire, the Tuberculosis Compliance Behavior Rating Scale, Perceived Social Support Scale and Self-efficacy for Appropriate Medication Use scale were used to investigate, and the correlation analysis and mediating effect analysis were carried out.Results:The total scores of compliance behavior, self-efficacy and perceived social support were (119.09 ± 13.49), (23.48 ± 6.25) and (55.67 ± 11.33) respectively. All dimensions of medication self-efficacy and perceived social support were positively correlated with compliance behavior ( r values were 0.555 - 0.943, all P<0.01), and medication self-efficacy was positively correlated with perceived social support ( r = 0.981, P<0.01). Medication self-efficacy played a partial mediating effect between perceived social support and compliance behavior, accounting for 74.46% of the total effect. Conclusions:The medication self-efficacy of young patients with newly treated pulmonary tuberculosis is the mediating variable between perceived social support and compliance behavior. Medical staff should focus on and carefully evaluate the medication self-efficacy and perceived social support of patients, so as to give supportive intervention in time, so as to change or even reverse the non-compliance behavior and improve the compliance level of patients.

Objective:To investigate the effects of ginsenoside Rg1 (GS-Rg1) on the secretion of exosomes (MSC-Exo) and expression of angiogenesis related microRNAs (miRNAs) in mesenchymal stem cells.Methods:Human umbilical cord blood mesenchymal stem cells (hUCBMSCs) were divided into experimental group and control group. The experimental group was treated with GS-RG1 at a final concentration of 40 mg/L, while the control group was treated with phosphate buffered saline (PBS) at the same volume. Both groups were cultured for 24 h. The morphology of MSC-Exo was observed by transmission electron microscopy; the characteristic surface markers were identified by Western blot; the concentration of MSC-Exo was detected by dicootanobutyric acid protein quantification method, and the expression of 8 miRNAs related to angiogenesis in MSC-Exo was detected by reverse transcription polymerase chain reaction (RT-PCR).Results:After 24 h of incubation, MSC-Exo with a circular membrane vesicle structure was visible. MSC-Exo was positive for the expression of the characteristic surface markers CD9, CD63 and TSG101. After 24 h of intervention, the concentration of MSC-Exo protein were (1.080±0.019)μg/μl and (0.881±0.032)μg/μl in the experimental group and control group, respectively, with statistically significant difference ( P<0.01). The expression of miR-126-3p, miR-21, miR-146a-5p and miR-125b-5p in the GS-Rg1 group were significantly higher than that in the control group, while the expression of miR-16-5p was significantly lower than that in the control group (all P<0.05). Conclusions:GS-Rg1 promotes the secretion of MSC-Exo and enhances the expression of angiogenesis-related miRNAs within Exo to promote angiogenesis.

Objective:To investigate the effects of mesenchymal stem cells-derived exosomes (MSC-Exos) secreted by mesenchymal stem cells (MSCs) induced by astragaloside IV (AS-IV) on the biological function and pyroptosis of human umbilical vein endothelial cells (HUVECs) injured by high glucose.Methods:After human umbilical cord blood mesenchymal stem cells (hUCBMSCs) were intervened with 400 mg/L of AS-IV, exosomes were extracted, and then the morphology and specific markers of exosomes were identified. Human umbilical vein endothelial cells (HUVECs) were cultured in a medium with a glucose concentration of 30 mmol/L to prepare a high glucose-impaired HUVECs model. High glucose-impaired HUVECs were randomly divided into experimental and model groups, with the experimental group intervened with 100 μg/ml of MSC-Exos and the model group intervened with an equal volume of PBS solution, while a blank control group was also set up. Cell counting Kit-8 (CCK-8) cell proliferation assay, adhesion assay, matrigel tube formation assay and scratch assay were used to detect the effects of AS-IV-mediated MSC-Exos on the proliferation, adhesion, tube formation and migrationability of HUVECs; Western blot and real time fluorescence quantitative polymerase chain reaction (qRT-PCR) were used to detect the protein and mRNA expression of scorch death-related molecules, such as Caspase-1, GSDMD (Gasdermin D) and NLRP3 in each group.Results:The proliferation, adhesion number, tube number and migration width of HUVECs cells were significantly lower than those in the blank group ( P<0.05); The expression of Caspase-1, GSDMD, NLRP3 protein and their mRNA increased significantly ( P<0.001); Under the intervention of MSC-Exos mediated by AS-IV, the cell proliferation, adhesion number, tube number and migration width of HUVECs were significantly higher than those in the model group ( P<0.05); The expression of Caspase-1, GSDMD, NLRP3 protein and their mRNA decreased, with statistically significant difference ( P<0.05). Conclusions:AS-IV mediated MSC-Exos can significantly improve the biological function of high glucose-impaired endothelial cells, and its mechanism may be related to anti-pyroptosis.

Objective To analyze the risk factors of thyroid nodule (TN) in Harbin City,Heilongjiang Province.Methods From November 2014 to January 2015,residents lived in Nangang,Daoli,Daowai districts and villagers of Xubao Town of Hulan District of Harbin City were selected as research subjects,who lived in the local regions for more than 5 years,a total of 2 650 people were surveyed.Influence factors of TN were surveyed by general survey,clinical examination and thyroid ultrasound examination.Logistic regression analysis was used to analyze relationships between various factors and TN in single factor analysis and multiple factors analysis.Results Excluding 36 cases with thyroid surgery history,the total prevalence of TN was 22.92％ (599/2 614),single factor Logistic regression analysis found that females [odds ratio (OR) =1.597,95％ confidence interval (CI) =1.328-1.919],elderly (OR =3.356,95％CI =2.699-4.173),living in cities and towns (OR =1.677,95％CI =1.391-2.021),obesity (OR =1.245,95％CI =1.036-1.497),history of hypertension (OR =1.766,95％CI =1.414-2.205) were the risk factors of TN.In multiple factors Logistic regression analysis,risk factors from high to low in the order were elderly (OR =3.076,95％CI =2.436-3.884),females (OR =1.819,95％CI =1.493-2.215),living in cities and towns (OR =1.701,95％CI =1.400-2.066),history of diabetes (OR =1.644,95％CI =1.235-2.189),obesity (OR =1.325,95％CI =1.085-1.618).Conclusions The risk factors of TN include living in cities and towns,females,elderly,obesity,history of hypertension or diabetes in Harbin City of Heilongjiang Province.