Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory disease around the world, and pharmacotherapy is the foremost treatment method currently. In recent decades, with the rapid development of bronchoscopic interventional therapy, endoscopic physical ablation technology presents a therapeutic effect in treating COPD, with few treatment-related side effects, showing excellent application prospects in treating COPD. Since ablation techniques in this field are emerging technologies with low patient acceptance, they are not widely used in the clinical treatment of COPD. This article reviews the development process of physical ablation techniques. Moreover, their current application status and the prospects in the field of COPD treatment are also summarized and analyzed. We hope to promote the application of physical ablation in the clinical treatment of COPD and provide practical references and a theoretical basis for the clinical treatment of COPD.

Background The Inner Mongolia Autonomous Region is a vast area with a wide array of ecological environments, resulting in considerable regional variations in air pollution characteristics. Current research is limited by a scarcity of systematic, region-wide studies and risk assessments. Objective To assess the health risks associated with inhalation exposure to nine heavy metal and metalloid elements in atmospheric fine particulate matter (PM_2.5) for the population of the Inner Mongolia Autonomous Region. Methods From the 10th to the 16th of each month throughout 2023, atmospheric PM_2.5 samples were collected at designated monitoring sites in 12 leagues (cities) across the Inner Mongolia Autonomous Region to analyze the characteristics and trends in concentration. The health risk assessment model developed by the United States Environmental Protection Agency was employed to evaluate both the non-carcinogenic and carcinogenic risks associated with the heavy metal elements beryllium (Be), cadmium (Cd), chromium (Cr), hydrargyrum (Hg), plumbum (Pb), manganese (Mn), and nickel (Ni) and the metalloid elements stibium (Sb) and arsenic (As). Results In 2023, a total of 1206 valid PM_2.5 samples were analyzed from the Inner Mongolia Autonomous Region. The annual average PM_2.5 concentrations in Inner Mongolia, as well as in the cities of Ordos, Wuhai, and the Alxa League, all exceeded the national limit of 35 μg·m⁻³. The PM_2.5 concentrations across the leagues (cities) exhibited a clear seasonal variation, peaking in winter, followed by spring, and reaching a minimum in summer and autumn. The median PM_2.5 concentration in Ordos throughout the year was higher than that in the other leagues (cities) of the region. Concerning health risks, the non-carcinogenic risks associated with the 9 elements detected in each league (city) were all below 1, indicating acceptable levels. However, the non-carcinogenic risk values for Mn, Cr, and As were relatively high; specifically, Ordos City displayed the highest non-carcinogenic risk values for Mn (7.74×10⁻¹) and Cr (2.97×10⁻²), while Chifeng City recorded the highest value for As (2.34×10⁻³). The carcinogenic risk values for As, Cd, Cr, and Ni fell within the range of 1×10⁻⁹ to 1×10⁻⁵, representing an acceptable level. The health risks varied with age, and the elderly residents faced the highest non-carcinogenic and carcinogenic health risks. Conclusion While the carcinogenic and non-carcinogenic risks from heavy metals and metalloids within atmospheric PM_2.5 in the Inner Mongolia Autonomous Region are generally within acceptable limits, the potential risks that Mn, As, and Cr pose to the health of elderly people warrants particular attention, and Ordos and Chifeng cities exhibit notably higher health risks among other areas. It is recommended that regular, long-term monitoring be conducted, taking into account the specific conditions at monitoring sites across each league (city), and that targeted air quality management strategies be implemented to protect public health.

Objective:To construct the gemcitabine resistant cell lines of human pancreatic cancer cell line (PANC1) and mouse pancreatic cancer cell line (PANC02), and to investigate their biological behavior changes.Methods:Gemcitabine-resistant cell lines PANC1-GR of human pancreatic cancer and PANC02-GR of mouse pancreatic cancer were induced by concentration gradient increment method. Cell count assay (CCK-8), flow cytometry, cell scratch assay and Transwell assay were used to detect the drug resistance, proliferation, cell cycle, migration and invasion of the four groups of cell lines. The drug-resistant cells were also compared with the parent cells.Results:The resistance indices of PANC1-GR and PANC02-GR were 153.3 and 185.4, respectively. The results of CCK-8 showed that with the increase of gemcitabine concentration, the proliferation of resistant cells changed significantly compared with parental cells, the population doubling time of PANC1-GR was significantly shorter than that of PANC1 (1.5±0.1) d vs (2.4±0.2) d ( t=8.00, P<0.001). The proportion of cells in S and G2/M phase increased, and the proportion of cells in G0/G1 phase decreased. The cell scratch and Transwell experiments indicated that the 24h mobility of PANC1-GR and PANC02-GR was higher than that of parent cells (47.6±2.4)% vs (28.7±6.3)% and (53.6±3.2)% vs (30.1±1.4)%, the number of individual field (200 times magnification) penetrating membrane cells was also higher than that of parent cells (269.7±30.9) vs (62.7±10.1) and (172.0±30.8) vs (36.3±4.9), with statistical significance (all P<0.05). Conclusion:Concentration gradient increment method can successfully establish gemcitabine-resistant pancreatic cancer cell lines, which have stronger proliferation, migration and invasiveness, and can be used to study the mechanism of drug resistance in pancreatic cancer.

Objective:To explore the relationship between general demographic characteristics,inflammatory indicators,nutritional indicators,pathological data and lymph node metastasis in endometrial cancer(EC)pa-tients,and to construct and validate a model for preoperative prediction of lymph node status in endometrial canc-er patients.Methods:The preoperative clinical data of 473 patients with EC who underwent surgical treatment in the Zhu Jiang Hospital of Southern Medical University from January 2010 to April 2024 were retrospectively ana-lyzed.The independent risk factors of lymph node metastasis of endometrial cancer were screened by univariate and multivariate Logistic regression analyses,and the nomogram prediction model was constructed by R soft-ware.The performance of the model was evaluated by the receiver operating characteristic(ROC)curve,calibra-tion curve and clinical decision curve.Results:Menopausal status,high grade biopsy pathology,CA125 ≥24.47U/ml,systemic immune inflammatory index(SII)≥710.91,and prognostic nutritional index(PNI)＜52.90 were in-dependent risk factors for lymph node metastasis in endometrial cancer(OR＞1,P＜0.05).The nomogram model constructed based on these five factors had an AUC of 0.853 in the training set and 0.871 in the test set.The cali-bration curve fitted well,and the clinical decision curve shows a positive benefit.Conclusions:The endometrial cancer lymph node metastasis prediction model constructed based on menopausal status,biopsy pathology,CA125,SII,and PNI has good accuracy and fit,with certain clinical application value.

Objective:To explore the relationship between general demographic characteristics,inflammatory indicators,nutritional indicators,pathological data and lymph node metastasis in endometrial cancer(EC)pa-tients,and to construct and validate a model for preoperative prediction of lymph node status in endometrial canc-er patients.Methods:The preoperative clinical data of 473 patients with EC who underwent surgical treatment in the Zhu Jiang Hospital of Southern Medical University from January 2010 to April 2024 were retrospectively ana-lyzed.The independent risk factors of lymph node metastasis of endometrial cancer were screened by univariate and multivariate Logistic regression analyses,and the nomogram prediction model was constructed by R soft-ware.The performance of the model was evaluated by the receiver operating characteristic(ROC)curve,calibra-tion curve and clinical decision curve.Results:Menopausal status,high grade biopsy pathology,CA125 ≥24.47U/ml,systemic immune inflammatory index(SII)≥710.91,and prognostic nutritional index(PNI)＜52.90 were in-dependent risk factors for lymph node metastasis in endometrial cancer(OR＞1,P＜0.05).The nomogram model constructed based on these five factors had an AUC of 0.853 in the training set and 0.871 in the test set.The cali-bration curve fitted well,and the clinical decision curve shows a positive benefit.Conclusions:The endometrial cancer lymph node metastasis prediction model constructed based on menopausal status,biopsy pathology,CA125,SII,and PNI has good accuracy and fit,with certain clinical application value.

Objective To explore the perioperative trend of heart rate variability(HRV)in patients undergoing aortic valve replacement(AVR)under cardiopulmonary bypass and investigate the influence of age and/or postoperative atrial fibrillation(POAF)on this trend.Methods Baseline and clinical data of 134 patients undergoing AVR due to aortic valve disease in Department of Car-diovascular Surgery of Northern Theater General Hospital of PLA from January 2021 to January 2023 were collected and retrospectively studied.According to the age and/or POAF,they were divided into group A(aged＜60 years,no POAF,49 cases),group B(aged＜60 years,complicated with POAF,21 cases),group C(aged≥60 years,no POAF,30 cases)and group D(aged≥60 years,with POAF,34 cases).The dynamic electrocardiogram indicators were collected in 7 d be-fore and 7 d after operation.The changes in perioperative HRV were also observed.Results After operation,the standard deviation of sinus heart beat RR intervals,average of the standard devia-tions of NN intervals for each 5 min segment of a 24 h HRV recording(SDNNidx),root mean square of successive RR interval differences,and percentage of successive RR intervals that differ by more than 50 ms were significantly lower than those in 7 d before operation[61.172±17.449 ms vs 804.567±230.518 ms,20.284±9.432 ms vs 42.933±12.876 ms,1.307±0.196 ms vs 1.412±0.148 ms,3.00(1.30,7.23)ms vs 5.30(3.00,10.40)ms,P＜0.01].The group D had obvi-ously lower SDNNidx than the group A in 7 d after surgery(42.568±14.749 ms vs 46.467±11.754 ms,P＜0.05).Conclusion Autonomic dysfunction is observed in the early stage after AVR.For the patients aged≥60 years with POAF,the HRV indicators are significantly decreased,the dys-function of the vagus nerve is aggravated,and the disorder is exacerbated because of their syner-gistic effect.

Objective To explore the perioperative trend of heart rate variability(HRV)in patients undergoing aortic valve replacement(AVR)under cardiopulmonary bypass and investigate the influence of age and/or postoperative atrial fibrillation(POAF)on this trend.Methods Baseline and clinical data of 134 patients undergoing AVR due to aortic valve disease in Department of Car-diovascular Surgery of Northern Theater General Hospital of PLA from January 2021 to January 2023 were collected and retrospectively studied.According to the age and/or POAF,they were divided into group A(aged＜60 years,no POAF,49 cases),group B(aged＜60 years,complicated with POAF,21 cases),group C(aged≥60 years,no POAF,30 cases)and group D(aged≥60 years,with POAF,34 cases).The dynamic electrocardiogram indicators were collected in 7 d be-fore and 7 d after operation.The changes in perioperative HRV were also observed.Results After operation,the standard deviation of sinus heart beat RR intervals,average of the standard devia-tions of NN intervals for each 5 min segment of a 24 h HRV recording(SDNNidx),root mean square of successive RR interval differences,and percentage of successive RR intervals that differ by more than 50 ms were significantly lower than those in 7 d before operation[61.172±17.449 ms vs 804.567±230.518 ms,20.284±9.432 ms vs 42.933±12.876 ms,1.307±0.196 ms vs 1.412±0.148 ms,3.00(1.30,7.23)ms vs 5.30(3.00,10.40)ms,P＜0.01].The group D had obvi-ously lower SDNNidx than the group A in 7 d after surgery(42.568±14.749 ms vs 46.467±11.754 ms,P＜0.05).Conclusion Autonomic dysfunction is observed in the early stage after AVR.For the patients aged≥60 years with POAF,the HRV indicators are significantly decreased,the dys-function of the vagus nerve is aggravated,and the disorder is exacerbated because of their syner-gistic effect.

Objective:To construct the gemcitabine resistant cell lines of human pancreatic cancer cell line (PANC1) and mouse pancreatic cancer cell line (PANC02), and to investigate their biological behavior changes.Methods:Gemcitabine-resistant cell lines PANC1-GR of human pancreatic cancer and PANC02-GR of mouse pancreatic cancer were induced by concentration gradient increment method. Cell count assay (CCK-8), flow cytometry, cell scratch assay and Transwell assay were used to detect the drug resistance, proliferation, cell cycle, migration and invasion of the four groups of cell lines. The drug-resistant cells were also compared with the parent cells.Results:The resistance indices of PANC1-GR and PANC02-GR were 153.3 and 185.4, respectively. The results of CCK-8 showed that with the increase of gemcitabine concentration, the proliferation of resistant cells changed significantly compared with parental cells, the population doubling time of PANC1-GR was significantly shorter than that of PANC1 (1.5±0.1) d vs (2.4±0.2) d ( t=8.00, P<0.001). The proportion of cells in S and G2/M phase increased, and the proportion of cells in G0/G1 phase decreased. The cell scratch and Transwell experiments indicated that the 24h mobility of PANC1-GR and PANC02-GR was higher than that of parent cells (47.6±2.4)% vs (28.7±6.3)% and (53.6±3.2)% vs (30.1±1.4)%, the number of individual field (200 times magnification) penetrating membrane cells was also higher than that of parent cells (269.7±30.9) vs (62.7±10.1) and (172.0±30.8) vs (36.3±4.9), with statistical significance (all P<0.05). Conclusion:Concentration gradient increment method can successfully establish gemcitabine-resistant pancreatic cancer cell lines, which have stronger proliferation, migration and invasiveness, and can be used to study the mechanism of drug resistance in pancreatic cancer.

OBJECTIVE To investigate the efficacy and safety of ropivacaine combined with oxycodone for the analgesia of iliac fascia nerve block in patients undergoing hip replacement.METHODS Sixty-six patients who underwent hip replacement at the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from October 2023 to April 2024 were selected and randomly divided into observation group and control group,with 33 cases in each group.Before induction of anesthesia,ultrasound-guided iliac fascial nerve block was performed.Patients in the observation group were treated with 0.33%ropivacaine+0.1 mg/kg oxycodone injection mixture 30 mL,and patients in the control group were treated with 0.33%ropivacaine injection 30 mL.The time of first postoperative rescue analgesia,24 h postoperative analgesic drug consumption,sensory block and motor block effective and maintenance time,satisfaction degree,numerical rating scale(NRS)pain score,Ramsay sedation score,muscle strength score,heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO2),sleep score,anxiety score,and the occurrence of adverse reactions in the two groups were all recorded.RESULTS Compared with the control group,the first rescue analgesia time after operation was significantly prolonged in the observation group,and 24 h postoperative analgesic drug consumption after operation decreased;the effective time of sensory block was significantly shortened,and the maintenance time of sensory block was significantly prolonged,and the satisfaction score was higher;the NRS pain score after iliac fascia nerve block was lower,HR and MAP were lower,and the anxiety score and sleep score 24 and 48 h after operation were lower(P＜0.05).In terms of safety,patients in both groups had adverse reactions after operation,such as hypertension,nausea,vomiting,and dizziness,but there was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).CONCLUSIONS Oxycodone combined with ropivacaine shows good efficacy and safety for iliac fascial nerve block analgesia in patients undergoing hip replacement,can significantly prolong the analgesic time of ropivacaine,reduce postoperative analgesic drug consumption,improve the sleep quality of patients,and promote the rapid recovery of patients.

Objective To investigate the clinical and cytogenetic characteristics of acute myeloid leukemia(AML)patients with NRAS mutations.Methods Newly diagnosed AML patients in our hospital from January 2020 to August 2022 were selected,and their clinical data were retrospectively analyzed.According to NRAS mutations,the patients were divided into NRAS mutation group and NRAS wild group.The clinical characteristics and cytogenetic differences were compared between the two groups.Results A total of 162 newly diagnosed AML patients were included in this study.There were 28 in NRAS mutation group and 134 in NRAS wild group.The peripheral white blood cell count of NRAS mutation group was significantly higher than that of NRAS wild type group(53.10×109/L vs 24.78×109/L,P<0.05).There were no significant differences in the hemoglobin level,platelet count or bone marrow blast cell count between the two groups(P>0.05).The coexisting gene mutation occurred in 25 patients(89.3%,25/28)in NRAS mutation group.The most common coexisting gene mutation was KRAS,with a mutation rate of 28.6%.Compared with NRAS wild group,NRAS mutation group was more likely to obtain KRAS mutations(P<0.05).There was no significant difference in other coexisting mutated genes between the two groups(P>0.05).The proportion of poor prognosis karyotype in the NRAS mutation group was 23.1%,which was significantly higher than that in NRAS wild group(P<0.05).The proportions of favorable and intermediate prognosis karyotypes in NRAS mutation group were 7.7%and 69.2%,respectively,which were not significantly different from those in NRAS wild group(P>0.05).Conclusion The incidence of NRAS mutation is 17.3%in AML patients in this study.Patients with NRAS mutation are more likely to have KRAS mutation and have a higher proportion of poor prognosis karyotype.