Objective    To explore the safety and feasibility of uni-portal video-assisted thoracic surgery (VATS) for the treatment of bronchopulmonary sequestration (BPS). Methods    The clinical data of BPS patients with surgical resection in Shanghai Pulmonary Hospital from February 2010 to June 2021 were reviewed. The patients were divided into a VATS group and a thoracotomy group according to the operation method. The operation time, intraoperative blood loss, hospital stay and postoperative complication rate were compared between the two groups. The VATS group was subdivided into a uni-portal VATS group and a multi-portal VATS group for subgroup analysis. Results    Finally 131 patients were enrolled, including 62 males and 69 females with an average age of 39.3±13.2 years. There were 103 patients in the VATS group and 28 patients in the thoracotomy group. A total of 104 patients were diagnosed with left lower BPS, 26 with right lower BPS and 1 with bilateral lower BPS. The main symptom was cough (88 patients, 67.2%). There were 119 patients diagnosed by thoracic enhanced CT before operation. Compared with the thoracotomy group, the operation time was not statistically different (P=0.717), but the blood loss was less, the rate of postoperative complication was lower and hospital stay was shorter in the VATS group (P<0.05). The rate of conversion to open surgery in the uni-portal VATS group and multi-portal VATS group was 11.8% and 13.5%, respectively. Meanwhile, patients in the uni-portal VATS group had shorter operation time and postoperative hospital stay, less blood loss and lower postoperative complication rate than those in the multi-portal VATS group (P<0.05). Conclusion     In order to improve the rate of diagnosis, the lung enhanced CT scan should be selected as an optimal noninvasive method in adult suspected patients (especially those with solid cystic and solid lesions in the lower lobe). Uni-portal VATS is a safe and feasible method for BPS which can be widely promoted.

OBJECTIVE To study the effects of bergapten in the treatment of liver fibrosis and its mechanism based on serum metabolomics. METHODS Forty mice were divided into normal control group （0.5% carboxymethyl cellulose sodium solution）， model group （0.5% carboxymethyl cellulose sodium solution）， and BP low-dose and high-dose groups （50， 100 mg/kg）， with 10 mice in each group. Except for the normal control group， the other three groups were all treated with carbon tetrachloride to induce liver fibrosis model； they were given relevant medicine/solution intragastrically， once a day， for consecutive 8 weeks. After the last medication， the levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） in serum were detected， and liver pathological changes were observed； the expressions of α-smooth muscle actin （α-SMA） and Collagen Ⅰ were detected in liver tissue； the serum of the mice was collected for metabolomics analysis. RESULTS Compared with the model group， serum levels of ALT and AST and protein expressions of α-SMA and Collagen Ⅰ in liver tissue were decreased significantly in BP high-dose and low-dose groups （P＜0.05）， while liver fibrosis was improved significantly. Meanwhile， metabolomics analyses showed that there were a total of 175 serum differential metabolites in the BP high-dose group and model group， of which 18 substances were upregulated and 157 substances were downregulated； the main metabolic pathways involved in bergapten intervention were pyrimidine metabolism， butanoate metabolism， fatty acid synthesis， tyrosine metabolism， β-alanine metabolism， nicotinic acid and nicotinamide metabolism， glutathione metabolism， etc. CONCLUSIONS BP is effective in the treatment of liver fibrosis by regulating pyrimidine metabolism， butanoate metabolism， glutathione metabolism and so on in rats with liver fibrosis.

Humans ; China/epidemiology* ; SARS-CoV-2 ; COVID-19

Objective:To explore the influencing factors of postoperative graft stenosis in patients undergoing left internal mammary artery-left anterior descending branch (LIMA-LAD) coronary artery bypass graft (CABG) surgery.Methods:A retrospective analysis of the clinical data of 86 patients who were admitted to the Second Affiliated Hospital of Hainan Medical College and received coronary angiography after CABG surgery from July 2019 to December 2020 due to recurrent chest tightness, chest pain and other symptoms. According to the degree of stenosis of the LIMA-LAD graft, the patients were divided into stenosis group ( n=25) and non-stenosis group ( n=61). The graft stenosis of patients in the stenosis group was ≥50%, and the graft stenosis of patients in the non-stenotic group was less than 50%. The general information, past medical history, CABG intraoperative data, current visit data and biochemical indicators of the two groups were compared. Measurement data were expressed as mean±standard deviation ( Mean± SD), comparison between groups was by t-test; count data comparison between groups was by Chi-square test. Logistic regression analysis was used to screen out the influencing factors of graft stenosis after CABG. Use the rms package in the R 4.0.2 software to build a nomogram prediction model. Using receiver operating characteristic (ROC) curve to evaluate the discriminative degree of the model. Use the calibration curve and deviation correction C-index to evaluate the nomogram prediction model. Use X-tile software to obtain the cutoff value of the nomogram model integral, use Kaplan-Meier method to draw the survival curve, and use Log-rank to test. Results:Logistic regression analysis showed that smoking, hypertension, pre-CABG left anterior descending branch (LAD) stenosis <75%, pre-CABG left internal mammary artery (LIMA) blood flow, and coronary angiography diffuse lesions are independent risk factors that affect LIMA-LAD graft stenosis after CABG ( P<0.05). The C-index value predicted by the nomogram model was 0.879 (95% CI: 0.818-0.955, P<0.001). The area under the ROC curve was 0.712 (95% CI: 0.594-0.801, P<0.001), with good discrimination. The calibration curve shows that the accuracy of the model prediction was good. Through the X-tile software screening to obtain the model score cutoff value, the patients were divided into low-risk group (≤54 points), medium-risk group (>54 points and ≤112 points), and high-risk group (>112 points). The results of survival analysis showed that the incidence of postoperative graft stenosis in the three groups was 20.9%, 50.0% and 80.0%, respectively. Conclusions:Smoking, hypertension, LAD stenosis before CABG <75%, LIMA blood flow before CABG, and coronary angiography diffuse lessions are independent risk factors that affect LIMA-LAD graft stenosis after CABG. The construction of a nomogram prediction model can provide a reference for evaluating the patency of the LIMA-LAD graft vessel before CABG operation, and reduce the probability of LIMA-LAD graft vessel stenosis after CABG operation.

The outbreak of coronavirus disease 2019 (COVID-19) has spread rapidly around the world. As of May 30, 2020, a total of 84 568 confirmed COVID-19 cases have been recorded in China, with a mortality rate of approximately 5.5%. Taizhou is a prefecture-level city in Zhejiang Province. A total of 146 cases were diagnosed in this epidemic, with a fatality rate of 0%. This condition is due to the establishment of an "Internet +" diagnosis and treatment model based on online medical application (APP), telemedicine, WeChat service, and consultation hotline in Taizhou. Taizhou led in opening the "COVID-19 Prevention and Treatment Special Line" in China, which is conducive to pre-hospital screening, suppressing social panic, and clinical support. Hospitals also carried out related online lectures and popularization of science. We summarize Taizhou's COVID-19 prevention and control experience with telemedicine features, with a view to providing reference for the control of the epidemic at home and abroad.
Betacoronavirus ; China ; Coronavirus Infections ; prevention & control ; Humans ; Internet ; Pandemics ; prevention & control ; Pneumonia, Viral ; prevention & control ; Telemedicine ; organization & administration

ObjectiveTo verify the reliability of the mouse model of cerebral cortical microinfarct induced by two-photon microscopy and to explore its pathological changes.MethodsSeventeen male C57BL/6J mice were randomly divided into a microinfarct group (n=11) or a sham operation group (n=6).A thinned cranial window of 3 mm diameter was performed over the cerebral cortex with a high-speed micro-drill until the small blood vessels were clearly observed under a dissecting microscope.Then, a permanent single cortical penetrating arteriole occlusion was induced with a gradually enhanced ultrashort laser irradiation through the thinned cranial window with two-photon microscopy.At 7 days after modeling, the cerebral microinfarct volume was measured with HE staining, and the neuron loss, activation of glial cells and deposition of 3-nitrotyrosine were assessed using immunohistochemistry.ResultsThe target vessels of cerebral cortex in 8 (72.7%) mice were occluded and the microinfarcts formed in the microinfarct group, and the average microinfarct volume was 317.23±20.29 μm3.There were remarkable neuron loss and microglia infiltration in the infarcted core, a large number of reactive astrocytes surrounding the infarcted lesion, and massive deposition of 3-nitrotyrosine in the peri-infarct area.No infarcts were observed in the sham operation group.The deposition of 3-nitrotyrosine in the sham operation group was significantly less than that in the microinfarct group (8.00±1.48 vs.98.38±9.10;t=23.962, P<0.001).Conclusions The mouse model of cerebral cortical microinfarct induced by two-photon microscopy is reliable, and its histopathologic changes are consistent with the pathologic features of cerebral microinfarct.

Objective To systematically review the efficacy and safety of mini-percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopic lithotripsy (FURL) in management of lower pole kidney stones.Methods PubMed, Embase, Scopus, Cochrane library, CNKI, VIP and Wanfang Data were searched from the beginning of database to September 2016 and clinical trials that compared the two above operation for treatment of lower pole stones were collected.Two researchers independently filtered literature,extracted data and evaluated the methodological quality of research papers.The meta-analysis was performed using the RevMan 5.3 software.Results One randomized and seven non-randomized studies were analyzed, which consists of 621 patients including MPCNL group 327 cases, FURL group 294 cases.The results of meta-analysis showed that MPCNL was better than FURL in stones clearance (OR =2.65,95％ CI 1.58-4.46,P ＜ 0.01) and operative time (WMD =-21.86,95％ CI-28.52--15.20, P ＜ 0.01).FURL was better in hospital stay time (WMD =2.28,95％ CI 0.29-4.28, P =0.02), decrease in haemoglobin levels (WMD =0.78,95 ％ CI 0.68-0.89, P ＜ 0.01), bleeding (OR =5.11,95 ％ CI 1.12-23.31,P =0.04), transfusion(OR =7.04,95％ CI 1.59-31.15, P =0.01).There was no significant difference in fever,urinary tract infection, hematuria (P ＞ 0.05).Conclusions Both MPCN and FURL are safe and effective for the treatment of lower pole stones, MPCNL can get higher stone clearance rates and shorter operation time.However, FURL can get shorter hospitalization time and lower complication rates.

Objective To investigate whether the median(50%)effective effect-concentration(EC50)of propofol inducing loss of consciousness (LOC) varies. Methods 56 patients undergoing gastroscopy under general anaesthesia were enrolled on the study. Anaesthesia was conducted with a target-controlled infusion(TCI) of propofol. The initial target effect-site propofol concentration (Ceprop) was 5.00 μg/mL and was adjusted stepwise by 0.50μg/mL by an up-down sequential method to reach no-movement. Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety(6.46μg/mL vs. 5.75μg/mL,P<0.05). Conclusions During general anaesthesia ,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety. Differences in preoperative anxiety levels may reduce anaesthetic effects.

Objective To observe the effect of Huangxiong Kangshuan capsule on serum high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) levels in patients with acute cerebral infarction. Methods Ninety-two patients with acute cerebral infarction admitted to the First Affiliated Hospital of Anhui University of Traditional Chinese Medicinefrom July 2013 to December 2016 were enrolled, and they were divided into an observation group (47 cases) and a control group (45 cases) by random number table. The control group was given conventional treatment of ischemic cerebrovascular disease, while the observation group was additionally treated by Huangxiong Kangshuan capsule orally taken, once 3 tablets, 3 times a day, on the basis of routine treatment; the duration of treatment was 2 weeks in both groups. After 2 weeks of treatment, the clinical effects of the two groups and the changes of serum hs-CRP and IL-6 levels were observed.Results After treatment, the levels of serum hs-CRP and IL-6 were decreased significantly compared with those before treatment in the two groups [observation group: hs-CRP (mg/L) was 6.18±2.17 vs. 14.11±3.01, IL-6 (ng/L): 28.10±11.47 vs. 120.83±24.51; control group: hs-CRP (mg/L) was 8.89±2.46 vs. 13.97±2.69, IL-6 (ng/L) was 49.48±16.43 vs. 115.25±24.05], and the degree of decline in the observation group was more significant than that in the control group [hs-CRP (mg/L): 6.18±2.17 vs. 8.89±2.46, IL-6 (ng/L): 28.10±11.47 vs. 49.48±16.43, bothP < 0.01]; the total effective rate of the observation group was significantly higher than that of the control group [87.2% (41/47) vs. 71.1% (32/45),P < 0.05]. Conclusion Huangxiong Kangshuan capsule can decrease the serum hs-CRP and IL-6 levels in patients with acute cerebral infarction, and has a role in brain protection and nerve function defect improvement.

Objective To investigate the current prevalence of pubertal development in healthy Shanghai schoolchildren.Methods This study was a cross-sectional investigation focused on current pubertal development conducted in healthy Shanghai schoolchildren by multi-stage cluster sampling.The sample included 17 571 children in grades 1-5 investigated in June 2014.The data were weighted by inverse probability weighting (IPW) to make them more representative.At examination,stages of breast and pubic hair development were rated according to the Tanner method.Testicular volume was determined.Data on menarche and spermatorrhea were collected by the status quo method.The rates of precocious puberty,breast,and pubic hair development of Tanner stage ≥ Ⅱ in girls aged 6-7 years,menarche in girls aged 6-9 years,and testicular volume ≥4 ml and pubic hair development of Tanner stage ≥ Ⅱ in boys aged 6-8 years were calculated.All the data were weighted by IPW.Results After data processing,16 197 children's data were analyzed.In girls aged 6-7 years,17.2％ and 2.5％ showed evidence of breast and pubic hair development at Tanner stage ≥ Ⅱ,respectively.In girls aged 6-9 years,0.3％ had experienced menarche.Schoolgirls' rate of menarche was 4.7％.In girls aged 6-7 years,19.0％ were diagnosed with precocious puberty according to the classic criteria.In boys aged 6-8 years,1.7％ had testicular volume ≥4 ml,and 0.6％ showed evidence of pubic hair development at Tanner stage ≥ Ⅱ.Schoolboys' incidence rate of spermatorrhea was 0.1％.In boys aged 6-8 years,2.3％ were diagnosed with precocious puberty according to the classic criteria.All the numbers above were weighted.Conclusion Proper education on adolescence and sex is essential for Shanghai schoolchildren.