Objective:To explore the effects of pressure controlled ventilation-volume guaranteed (PCV-VG) mode on intraoperative pulmonary ventilation and postoperative pulmonary complications (PPC) in elderly patients undergoing thoracoscopic lobectomy.Methods:Sixty patients of American Society of Anesthesiologists (ASA) classification Ⅱor Ⅲ, aged 65-80 years old, with body mass index (BMI) 18-30 kg/m 2, received thoracoscopic lobectomy under general anesthesia from November 2021 to June 2022 in the Second Hospital of Shanxi Medical University were recruited. The patients were divided into PCV-VG and volume-controlled ventilation (VCV) groups using the randomized number table method, with 30 patients in each group. The ventilatory parameters of two-lung ventilation were set to respiratory rate (RR) at 10-12 breaths/min, with a tidal volume (VT) of 8 ml/kg (ideal body weight). The ventilatory parameters of one-lung ventilation (OLV) were set at 12-16 breaths/min, with a VT of 6 ml/kg (IBW). The peak airway pressure (Ppeak), plateau airway pressure (Pplat), driving pressure (ΔP), dynamic lung compliance (Cdyn), end-tidal carbon dioxide (ETCO 2), heart rate (HR), mean arterial pressure (MAP), partial pressure of oxygen (PaO 2) and partial pressure of carbon dioxide (PaCO 2) were obtained at 1 min before OLV (T 0), 30 min after OLV (T 1) and 60 min after OLV (T 2). The incidence and severity of PPC, chest tube duration time and postoperative hospital stay time were recorded. Results:The Ppeak, Pplat and ΔP were higher and Cdyn was lower in both groups at T 1-T 2 than at T 0 (all P<0.001). The Ppeak, Pplat and ΔP were higher and Cdyn was lower in PCV-VG group than in VCV group (all P<0.05). There were no statistical differences in HR, MAP, ETCO 2, PaO 2 and PaCO 2 between the two groups (all P > 0.05). There were no statistical differences in the incidence of PPC [43.3% (13/30) vs. 30.0% (9/30)] and chest tube duration time [(4.4±0.9) d vs. (4.2±1.2) d] between VCV group and PCV-VG group (all P>0.05). Compared with VCV group, the proportion of patients with ≥grade 2 PPC was lower in PCV-VG group [10.0% (3/30) vs. 36.7% (11/30), χ2=5.96, P<0.05]. The postoperative hospital stay time in PCV-VG group was shorter than that in VCV group [(6.4±1.3) d vs. (8.0±1.9) d, t = 4.85, P<0.05]. Conclusions:PCV-VG mode can effectively reduce the severity of PPC, shorten the postoperative hospital stay time and improve the prognosis in elderly patients undergoing thoracoscopic lobectomy.

Objective:To investigate the lung protective effect of driving pressure-guided lung protective ventilation strategy (LPVS) combined with pressure-controlled ventilation (PCV) in elderly patients undergoing thoracoscopic radical resection of lung cancer.Methods:One hundred elderly patients scheduled for thoracoscopic radical resection of lung cancer from April 2021 to April 2022 in the Second Hospital of Shanxi Medical University were selected. Patients were aged 60-80 years old and American Society of Anesthesiologists (ASA) classification Ⅰ-Ⅱ. All patients were divided into 4 groups by using the random number table method, with 25 cases in each group. Group A received volume-controlled ventilation (VCV) + 5 cm H 2O (1 cm H 2O = 0.098 kPa) PEEP, group B received PCV+5 cm H 2O PEEP, group C received VCV+driving pressure-guided individualized PEEP, and group D received PCV+driving pressure-guided individualized PEEP. The arterial oxygen partial pressure (PaO 2) was recorded before one-lung ventilation (OLV) (T 0), 30 min after OLV (T 1) and 60 min after OLV (T 2). The serum concentrations of neutrophil elastase (NE) in radial artery blood samples of patients were measured at T 0 and 10 min after the end of OLV (T 3). The occurrence of postoperative pulmonary complications (PPC) within 5 d after surgery was recorded. Results:The PaO 2 of group A and B at T 1 [(135±50), (146±51) mmHg (1 mmHg = 0.133 kPa)] and T 2 [(137±46), (143±47) mmHg] were lower than those of group C and group D at T 1 [(168±27), (190±30) mmHg] and T 2 [(180±30), (183±24) mmHg] (all P < 0.05). The incidence of PPC within 5 d after surgery in group A was higher than that in group D [36% (9/25) vs. 4% (1/25)] ( P = 0.005). The concentration of NE at T 3 in group A [(202.8±9.7) ng/ml] was lower than that in group B, C and D [(182.5±12.0), (180.0±10.3), (160.6±13.0) ng/ml] ( P < 0.05). Conclusions:During OLV, driving pressure-guided LPVS combined with PCV can not only improve oxygenation, but also show obvious advantages in reducing inflammatory response. It is a safe and effective intraoperative ventilation strategy for elderly patients undergoing thoracoscopic radical resection of lung cancer.

Objective To study the expression of high mobility group box protein 4 (SOX4) and β-catenin in lung tissues of preterm rats with hyperoxia exposure,and to study its significance.Method One-day-old preterm Sprague Dawley rats were randomly assigned into 4 groups:95％ hyperoxia group,70％ hyperoxia group,45％ hyperoxia group and air group.After three days,pathological changes of the lung tissues were observed by hematoxylin eosin staining,the mRNA expressions of SOX4 and β-catenin in lung tissues were detected by semi-quantitative reverse transcription polymerase chain reaction,and the protein expressions of SOX4 and β-catenin in the lung tissues were measured by western blot.Result The structure of lung tissues in air group was normal.45％ hyperoxia group represented mainly effusion and inflammatory cell infiltration,70％ and 95％ hyperoxia group showed acute lung injury characterized by inflammatory cell infiltration,hyperaemia,hemorrhagic change,disorganization and collapse of alveolar.The expressions of SOX4 mRNA and protein were highly elevated in all hyperoxia groups than that in air group (P ＜ 0.01);Compared with 45％ hyperoxia group,the expressions of SOX4 mRNA and protein were higher in 95％ hyperoxia group (P ＜ 0.01).β-catenin mRNA,total β-catenin protein and nuclear β-catenin protein were also highly elevated in hyperoxia groups compared with air group (P ＜ 0.05).Compared with 45％ hyperoxia group,the expressions of β-catenin mRNA and total β-catenin protein were also highly raised in 70％ hyperoxia group and 95％ hyperoxia group (P ＜ 0.05).The expression of nuclear β-catenin protein was higher in 95％ hyperoxia group than that in 45％ hyperoxia group (P ＜ 0.01).Conclusion The mRNA and protein expressions of SOX4 and β-catenin in lung tissues of preterm rats were increased by hyperoxia exposure.This mechanism may take part in hyperoxia-induced preterm rats lung injury.

Objective To observe the levels of peripheral blood cytokines interferon-γ (IFN-γ)and interleukin-4 (IL-4) in patients with acute and chronic brucellosis before and during treatment,and to understand the differences of two immunocytokines in acute and chronic stage of brucellosis,and the effect of antibacterial therapy on these two cytokines to provide immunological basis for clinical evaluation of the therapeutic effect of brucellosis.Methods Research subjects were 36 pre-treatment acute brucellosis and 36 pre-treatment chronic brucellosis and 36 dur-treatment acute brucellosis and 36 dur-treatment chronic brucellosis,which were selected from Ulanqab Center for Endemic Disease Prevention and Control of Jining City with 25 local healthy persons as healthy controls.The levels of IFN-γ and IL-4 in serum were measured by enzyme-linked immunosorbent assay (ELISA) in patients with acute and chronic brucellosis and control group before and during treatment.Parameters of IFN-γ and IL-4 were analyzed with One-Way ANOVA analysis in pre-treatment and dur-treatment acute brucellosis,chronic brucellosis and control groups.Results The means of IFN-γ [(462.79 ± 47.94),(431.92 ± 40.39),(280.50 ± 40.48) ng/L] and IL-4 [(606.11 ± 51.86),(550.66 ± 51.56),(383.24 ± 53.98) ng/L] were significantly different in the three groups before treatment (F =141.84,139.28,P ＜ 0.05);Compared to control group,the levels of IFN-γ and IL-4 in acute brucellosis and chronic brucellosis were significantly increased before treatment (P ＜ 0.05).The levels of IFN-γand IL-4 in the acute brucellosis were significantly increased compared to those of chronic brucellosis before treatment (P ＜ 0.05).After about ten days antibiotic therapy,the means of IFN-γ [(356.05 ± 43.75),(368.61 ± 35.69),(280.50 ± 40.48) ng/L] and IL-4 [(487.31 ± 51.59),(496.73 ± 48.70),(383.24 ± 53.98) ng/L] were significantly different in the three groups (F =39.57,41.99,P ＜ 0.05).Compared to control group,the levels of IFN-γ and IL-4 in acute brucellosis and chronic brucellosis were significantly increased during treatment (P ＜ 0.05).The levels of IFN-γand IL-4 in the acute brucellosis were not significantly different compared to those of chronic brucellosis during treatment (P ＞ 0.05).Conclusion Different immunological characteristics of cytokines in peripheral blood of patients with acute and chronic brucellosis before treatment have affected the therapeutic effect and clinical outcomes.

Objective To investigate the HOOF genotyping characteristics of 83 Brucella (B.)melitensis strains isolated in Ulanqab of Inner Mongolia Autonomous Region from 2012 to 2015.Methods A total of 83 B.melitensis strains were detected by convention identification and AMOS-PCR,then HOOF protocol with eight VNTR locus were used for the genotyping of the strains,and the allelic diversity of each VNTR locus and the discriminatory power of VNTR typing of HOOF were assessed by Hunter-Gaston Discriminatory index.BioNumerics 5.0 was used for phylogenetic analysis and constructing dendrogram.Results All of the isolates were identified as B.melitensis strains by two identification methods.The complete eight VNTR locus had higher polymophism and diversity index was 0.998;and diversity index of six locus (1,2 and 4-7) were ≥0.678,discriminatory power of HOOF was mainly from this six higher diversity index locus.The 83 B.melitensis strains were classified into eight clusters and 76 genotypes,6 shared genotypes included 13 isolates,indicating that these brucellosis cases had epidemiological link,the other 70 strains had distinct genotypes,indicating that these cases had no epidemiological link.Conclusions The epidemic of human brucellosis in Ulanqab was characterized by local and sporadic outbreaks.Cross infection was related with the transfer of the sources of infection.

Objective To investigate the effects of recombinant human erythropoietin (rhEPO) on the expression of vascular endothelial growth factor (VEGF) protein and mRNA in lung tissue of premature rat model of the new type bronchopulmonary dysplasia (BPD).Methods Lipopolysaccharide (LPS) or PBS was injected into 60 pregnant rats on the 15th day of gestation.The premature rats by cesarean delivery on the 21th day of gestation were divided into 5 groups:PBS+ air group,PBS+ hyperoxia group,LPS+hyperoxia group,PBS+hyperoxia+rhEPO group,LPS+hyperoxia+rhEPO group.In rhEPO intervention groups,after 6 h exposure to hyperoxia,rhEPO (1 200 IU/kg) was administrated subcutaneously,once every other day for 7 times.The survival rate,body weight,lung weight and lung weight/body weight ratio and pathological changes of lung tissue were observed,the expression levels of VEGF protein and mRNA in the lung tissue were determined by Western blot and RT-PCR at the 1st,7th and 14th day after hyperoxia exposure.Results Compared with the PBS+air group,the survival rate and body weight were decreased,the lung weight was increased,the lung pathological damages were more serious,the expression levels of VEGF protein and mRNA in lung tissue were decreased after hyperoxia exposure.These changes were more notable in the LPS+hyperoxia group (P＜0.05).The lung weight/body weight ratio showed an increasing tendency (P＞0.05).The above indexes were improved after rhEPO intervention (P＜0.05).Conclusion rhEPO could increase the survival rate and produce certain intervention and treatment effects by regulating the VEGF relative pathway in BPD model rats.

Objective To explore the change and value of interleukin (IL)-2,IL-6 and tumor necrosis factor (TNF)-α in the serum samples of patients with brucellosis.Methods The levels of serum IL-2,IL-6 and TNF-α were measured using the enzyme linked immunosorbent assay (ELISA) method in 155 patients with brucellosis in different clinical stages (including 69 cases in acute,34 cases in subacute and 52 cases in chronic periods) and 50 healthy controls.IL-2 was used to represent the helper T cell (Th)-type 1 cytokines,IL-6 represent Th2 type cytokines,and the Th1/Th2 ratio in different clinical stages was compared.Results The expression level of serum IL-2 in patients with brucellosis was different (ng/L:acute:10.15 ± 2.01;subacute:9.53 ± 1.68;chronic:6.76± 1.31;control:47.25 ± 5.68),the differences were statistically significant (F =74.921,P ＜ 0.05).The expression levels of serum IL-2 in acute,subacute and chronic periods of brucellosis patients were significantly lower than that of healthy controls (all P ＜ 0.05).The expression levels of serum IL-2 in acute and subacute periods of brucellosis patients were higher than that of chronic period patients (all P ＜ 0.05).The expression of IL-6 and TNF-α in serum of patients in different clinical stages were different (ng/L:acute:615.22± 341.07,802.55 ± 479.53;subacute:478.45 ± 105.33,680.21 ± 366.95;chronic:306.37 ± 96.12,455.36 ± 176.27;control:121.45 ± 30.16,87.51 ± 24.03),the differences were statistically significant (F =57.692,63.210,all P ＜ 0.05).The levels of serum IL-6 and TNF-o were significantly higher in patients with brucellosis in acute,subacute and chronic clinical stages than that of healthy controls (all P ＜ 0.05).Serum IL-6 and TNF-α levels in acute period of brucellosis patients were higher than those of subacute and chronic periods patients (all P ＜ 0.05);the levels of serum IL-6 and TNF-α in subacute period of brucellosis patients were also significantly higher than that of chronic period patients (all P ＜ 0.05).The Th1/Th2 ratio was different (acute:0.02 ± 0.00;subacute:0.02 ± 0.00;chronic:0.23 ± 0.02;control:0.41 ± 0.06) in clinical patients with brucellosis,the differences were statistically significant (F =17.843,P ＜ 0.05),the value of Th1/Th2 in acute and subacute period patients were lower than that of chronic period (all P ＜ 0.05).Conclusion IL-2,IL-6 and TNF-α may play an important role in the pathogenesis of brucellosis,and their dynamic changes can reflect the progression and outcome of brucellosis.

Objective To establish genotyping methods for rapid identification of Brucella melitensis (B.melitensis) biovar 1,2 and 3 and to verify these method.Methods Single nucleotide polymorphism of RpoB gene and tandem repeat sequence (TRS) Bru42 of standard reference strain 16M were used to design primers,then the RpoB-PCR and TRS-PCR method were established for identification of B.melitensis standard reference strains,these two methods were used to identify clinical isolates of B.melitensis and compared with the conventional methods.Results The results of B.melitensis standard reference strains (biotype 1,2,3) identified by RpoB-PCR and TRS-PCR were consistent with those of the conventional identification methods.Totally 50 clinical isolates [including B.melitensis biovar 1 (17),2 (3) and 3 (30)] were identified as RpoB-2 genotype,only one B.melitensis biovar 1 strain was identified as RpoB-3 genotype.Genotype identification results of standard reference strains and clinical isolates with the same biotype were not exactly the same.Fothermore,TRS-PCR experiment displayed that 51 clinical isolates were all genotype 2 of B.melitensis (genotype TRS-2).Conclusions There is no clear relationship between biovars and genotypes within B.melitensis,and significant difference exists between B.melitensis standard reference strains and clinical isolates within RpoB gene.Bru42 can not be used for genotyping clinical isolates of B.melitensis.

Objective To examine the psychometric properties of the Chinese version of behavioral regulation in sport questionnaire (BRSQ) among a sample of Chinese collegiate athletes.Methods The BRSQ was translated from English into Chinese using the translation and back translation approach.A sample of 334 Chinese collegiate athletes was invited to complete the questionnaire.Confirmatory factor analysis(CFA)and exploratory structure equation model(ESEM)approaches were used to examine the factor structure of the BRSQ.Moreover,the internal consistency reliability and nomological validity were examined.Results CFA results suggested that the 6-factor model(BRSQ-6)outperformed other measurement models.However,given the limitations of CFA approach in examining the factor structure of multidimensional instrument,ESEM was also used in this study because it could better present the underlying factor structure of the multidimensional scale.It was found that,as expected,the ESEM solution was better than CFA solution in representing the BRSQ-6 measurement model.The normological validity and internal consistency reliability of all BRSQ-6 subscales were also found acceptable.Conclusion In general,the BRSQ-6 Chinese version demonstrated satisfactory validity and reliability among Chinese collegiate athletes.It is noteworthy that unexpected cross-loading of some items have been identified,which implys that researchers should use the instrument with cautions.Future studies should be conducted to revise the problematic items.

Objective We compared peripheral blood nucleotide-binding oligomerization domain-leucinerich repeats containing pyrin domain 3 (NLRP3),cysteinyl aspartate specific proteinase-1 (Caspase-1),interleukin-1β (IL-1β) and IL-18 between acute and chronic brucellosis patients before treatment and revealed their immune characteristics,to find targets for immune intervention of brucellosis.Methods From March to April 2016,42 acute and 42 chronic brucellosis patients were selected from Ulanqab Center for Endemic Disease Prevention and Control as the research subjects,and 20 local healthy persons were selected as healthy control.Brucellosis were diagnosed according to the "Diagnostic Criteria of Brucellosis".Enzyme-linked immunesorbent assay (ELISA) method was used to determine serum levels of NLRP3,Caspase-1,IL-1β and IL-18.Results The expression levels of NLRP3,Caspase-1,IL-1β and IL-18 [(1 264.40 ± 424.74),(1 350.67 ± 468.93),(192.96 ± 61.52),(162.74 ±54.23),(172.44 ± 60.56),(120.10 ± 61.52),(47.23 ± 13.79),(46.68 ± 14.72),(27.71-± 8.71),(202.23 ± 65.24),(169.19 ± 54.33),(108.62 ± 41.39) ng/L] were compared in acute,chronic and control groups,the differences were statistically significant (F =61.96,6.26,16.68,18.31,P ＜ 0.01).Compared to control group,the levels of NLRP3,Caspase-1,IL-1β and IL-18 in acute and chronic groups were significantly increased (P ＜ 0.05);compared to chronic group,the levels of IL-18 in acute group were significantly increased (P ＜ 0.05),and NLRP3,Caspase-1 and IL-1 β levels were not statistically different (P ＞ 0.05).Conclusions This study has showed that the expression of NLRP3 inflammasome in innate immunity is not significantly different between acute brucellosis and chronic brucellosis.The difference of IL-18 levels between acute and chronic brucellosis may affect their immune response.