To summarize the nursing management experience of 9 patients with lung transplantation undergoing extracorporeal membrane oxygenation(ECMO)combined with continuous renal replacement therapy(CRRT)during perioperative period.The key points of nursing include forming a professional team to ensure the whole process management;comprehensive evaluation and pretreatment of adverse events during the operation to maintain the safe operation of the equipment;refined volume management based on the surgical process ensures intraoperative hemodynamic stability;optimization of intraoperative anticoagulation management to reduce the incidence of complications;multi-device safe transport management ensures the continuity of postoperative treatment.Through comprehensive and targeted nursing intervention,9 patients were successfully treated with ECMO combined with CRRT during the operation.The patients were transferred out of ICU 3～12 days after the operation,and were followed up for 3 months.The patient's condition is good.

To summarize the nursing management experience of 9 patients with lung transplantation undergoing extracorporeal membrane oxygenation(ECMO)combined with continuous renal replacement therapy(CRRT)during perioperative period.The key points of nursing include forming a professional team to ensure the whole process management;comprehensive evaluation and pretreatment of adverse events during the operation to maintain the safe operation of the equipment;refined volume management based on the surgical process ensures intraoperative hemodynamic stability;optimization of intraoperative anticoagulation management to reduce the incidence of complications;multi-device safe transport management ensures the continuity of postoperative treatment.Through comprehensive and targeted nursing intervention,9 patients were successfully treated with ECMO combined with CRRT during the operation.The patients were transferred out of ICU 3～12 days after the operation,and were followed up for 3 months.The patient's condition is good.

Neutrophils as the first immune responders to infection can quickly identify and eliminate pathogens. The mainly rely on glycolysis to exert their killing functions. Although researches on the metabolic shifs that affect neutrophil functions began early, little is known about how neutrophils undergo metabolic transformation during the anti-infection process. It has been proven that glycogen metabolism plays an important role in regulating the functions of neutrophils. Other metabolic pathways besides glycolysis, such as mitochondrial metabolism and fatty acid oxidation during neutrophil differentiation, have potential contributions to the regulation of neutrophils′ functions. This review summaries current studies about metabolic regulatory effects of neutrophils on anti-infection responses, intending to provide reference for further study on the metabolism of neutrophils.

Chronic hepatitis B （CHB） is still a malignant infectious disease that seriously threatens human health， and currently nucleos（t）ide analogues and interferon are the main treatment methods for CHB， but they cannot achieve functional cure. The development and progression of CHB are closely associated with immune function dysregulation in the host， and therefore， regulating host immunity has become a key link in the treatment of CHB. Recent studies have shown that traditional Chinese medicine exerts a therapeutic effect on CHB by regulating host immune function. This article introduces the relationship between traditional Chinese medicine theory and immunity and summarizes the theoretical basis and related studies for traditional Chinese medicine in the immune regulation of CHB， in order to provide new ideas for integrated traditional Chinese and Western medicine therapy for CHB.

Objective To study the efficacy and safety of bronchial artery embolization(BAE)with tris-acryl gelatin microspheres(TAGM)combined with platinum spring coil with fiber(microcoils)in the treatment of acute severe hemoptysis caused by bronchiectasis.Methods A retrospective analysis of 48 patients with bronchiectasis was performed.After the lesion vessels were confirmed by angiography,the distal capillary bed was embolized with TAGM(300-500 μm),the middle blood flow was embolized with microcoils according to the diameter of the small artery,and then the proximal vessels were embolized with TAGM(500-700 μm)again.In patients with pulmonary artery/vein fistula,appropriate TAGM(500-700 μm)was selected according to the size of the fistula and the blood flow velocity,followed by dense embolization with multiple microcoils.The complete occlusion of the lesion vessel was confirmed again by arteriography after embolization.Results The overall success rate of operation was 95.83％.There were 36 patients with immediately stopped bleeding,6 cases with effective treatment,4 cases with improved treatment,1 case with invalid treatment due to the leakage of the responsible blood vessel,which was improved after the second embolization.There was 1 case died in surgery due to sudden massive hemoptysis,choking and suffocation.During the 3-51 months follow-up,1 patient died due to sudden massive hemoptysis;4 patients had recurrent hemoptysis due to poor control of infection and collateral circulation,which were controlled after reemboliza-tion,and 1 patient with bronchiectasis and pulmonary tuberculosis had repeated hemoptysis caused by multiple pulmonary lesions and severe pulmonary infection,performing on four times embolization.There was no patient with recurrent hemoptysis occurring recanalization of primary embolized vessel.During the follow-up,the overall survival rate was 97.87％,and the hemoptysis control rate was 87.23％.Conclusion TAGM combined with microcoils is safe and effective in the treatment of acute massive hemoptysis,which has good short-term effect and long-term prognosis.

Objective: To investigate the prevalence of anxiety and depression among inpatients with AIDS and its influencing factors, so as to provide the evidence for improving the psychological health among inpatients with AIDS. Methods: The inpatients with AIDS that were hospitalized in an infectious disease hospital in Chengdu City were recruited using the convenient sampling method. The demographic features, depression and anxiety were collected using a self-designed questionnaire, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale ( SDS ), respectively, and factors affecting the development of depression and anxiety were identified using a multivariable linear regression model among inpatients with AIDS. Results: The 228 AIDS inpatients included 186 men (81.58%) and 42 women ( 18.42% ), and had a mean age of ( 48.04±16.03 ) years. There were 113 inpatients ( 49.56% ) with a CD4+T cell count of ≤200 cells/μL, and the mean SAS and SDS standardized scores were 35.87±8.01 and 42.07±11.08 among AIDS inpatients, which were both significantly greater than in normal populations ( P<0.05 ). The prevalence rates of anxiety, depression, and comorbid anxiety and depression were 5.26%, 16.23% and 4.82% among the participants, respectively. Multivariable linear regression analysis identified unemployment as a risk factor of anxiety ( β'=0.168, P<0.05 ), and CD4+T cell count as a risk factor of anxiety ( β'=-0.151, P<0.05 ) and depression ( β'=-0.238, P<0.05 ) among inpatients with AIDS. Conclusions Anxiety and depression are prevalent among inpatients with AIDS. Unemployment and a low CD4+T cell count may cause a rise in the risk of developing anxiety and depression among inpatients with AIDS.

OBJECTIVE: The explore the genetic basis for a patient with microcytic hypochromic anemia and iron deficiency anemia. METHODS: Common deletions and variants of the globin genes were detected by Gap-PCR and next generation sequencing (NGS). Suspected mutations were verified by Sanger sequencing. RESULTS: Gap-PCR and NGS showed that the proband has carried a αα/-α CONCLUSION Patients with α HBA2 c.2T>A(p.Met1Lys) α/-α
Anemia, Hypochromic/genetics* ; Codon, Initiator/genetics* ; Female ; Genetic Counseling ; Genetic Variation ; Genotype ; Humans ; Male ; Mutation ; Pregnancy ; Prenatal Diagnosis ; alpha-Globins/genetics* ; alpha-Thalassemia/genetics*

With the improvement of the quality of obstetric medical care, postpartum hemorrhage, the leading cause of maternal death, has received high attention. And pregnancy associated venous thromboembolism (PA-VTE) has gradually become one of the leading causes of maternal death. The clinical characteristics of PA-VTE and the particularity of treatment determine the importance of early assessment and prevention. This article reviews the risk factors and current assessment status of PA-VTE, in order to provide references for clinical risk assessment and prevention of VTE in pregnant women.

Objective:To systematically evaluate the intervention effect of oral immunotherapy (OIT) on ventilator-associated pneumonia (VAP) of premature infants.Methods:This study searched the Cochrane Library, PubMed, Embase, Web of Science, CINAHL, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure (CNKI) , WanFang Database and VIP Database, and conducted a comprehensive search for randomized controlled trials of OIT applied to premature infants published from database establishment to October 2020. Two researchers independently screened literature, extracted data, and evaluated methodological quality. RevMan 5.3 software was used for Meta-analysis.Results:A total of 8 studies were included, with a total of 351 premature infants in the intervention group and 352 premature infants in the control group. Meta-analysis results showed that OIT could reduce the incidence of VAP in premature infants [ RR=0.36, 95% CI (0.23-0.56) , P<0.05] and the detection rate of pathogenic microorganisms in the tracheal tube [ RR=0.33, 95% CI (0.18-0.59) , P=0.000 2], and could shorten the length of hospital stay [ MD=-6.70, 95% CI (-13.34--0.06) , P=0.05]. However, there was no statistically significant difference in the mechanical ventilation time, detection rate of oropharyngeal pathogenic microorganisms and mortality rate between the two groups after the intervention (all P>0.05) . Conclusions:OIT can reduce the incidence of VAP in premature infants and the detection rate of pathogenic microorganisms in the tracheal tube, and shorten the length of hospital stay to a certain extent. However, high-quality, large-sample, multi-center randomized controlled studies are still needed for further verification in the future.

Objective: To explore the efficacy of thoracoscopic bronchial sleeve lobectomy for central non-small cell lung cancer (NSCLC), and to evaluate the safety of this operation. Methods: The clinical data of 29 patients who underwent thoracoscopic bronchial sleeve lobectomy at Shanxi Provincial Cancer Hospital from May 2015 to September 2018 were retrospectively analyzed, and the surgical effect and safety were analyzed. Results: Twenty-nine cases underwent thoracoscopic bronchial sleeve lobectomy. The types of resection included 13 cases of right upper, 10 cases of left upper, and 6 cases of left lower sleeve lobectomy. The operation time was 180-400 min, and the median time was 240 min. The bronchial anastomosis time was 35-60 min, and the median time was 48 min. The intraoperative blood loss was 150-460 ml, and the median blood loss was 220 ml. The number of lymph node dissection was 12-39 lymph nodes per patient, with a median of 19.6 lymph nodes per patient. The thoracic drainage tube was placed for 4-16 days after operation, with a median of 6 days; the postoperative hospital stay was 6-16 days, with a median of 9 days. The postoperative complication rate was 24.1% (7/29), including 1 case with pulmonary air leakage (> 7 days), 2 cases with pulmonary infections, 3 cases with arrhythmia, and 1 patient discharged from the hospital on the 7th day after surgery, but died of anastomotic fistula bleeding on the 40th day. The rest of the patients recovered smoothly after surgery. The median follow-up time was 6 months (3-12 months). No tumor recurrence or anastomotic stenosis was observed. Conclusion Thoracoscopic bronchial sleeve lobectomy is a safe and feasible surgical treatment for central NSCLC.