Objective The study aimed to investigate the effect of Shen-Fu injection on the clinical efficacy and prognosis of gas-trointestinal dysfunction in patients with septic shock.Methods Patients diagnosed with septic shock in the Department of Critical Care Medicine of the First Hospital of Lanzhou University from September 2021 to April 2024 were enrolled and divided into the Shen-Fu group and the conventional treatment group according to the treatment plan.The propensity score matching(PSM)was used for 1∶1 matc-hing.Clinical data of patients in both groups at enrollment,the main gastrointestinal symptoms(vomiting,diarrhea,abdominal disten-sion,abnormal bowel sounds,gastric retention),blood lactic acid(Lac),interleukin(IL)-6,procalcitonin(PCT),white blood cell(WBC),neutrophil percentage(NEUT％),the ratio of lactic acid to creatinine(Lac/SCr)before and 5days after treatment,and the mortality rate 28days after discharge were recorded.Results Compared with conventional treatment group(35.06％),the total effective rate(66.23％)of gastrointestinal efficacy in Shen-Fu group 5days after treatment was significantly higher(x2=14.964,P＜0.05).The levels of Lac,WBC and Lac/SCr in Shen-Fu group was higher than that in conventional treatment group(P＜0.05).There was no significant difference in IL-6,PCT and NEUT％(P＞0.05).Compared with pre-treatment,the levels of IL-6,Lac,Lac/SCr de-creased after 5days of treatment in Shen-Fu group(P＜0.05),while there was no significant difference in PCT,WBC and NEUT％(P＞0.05).There was no statistically significant difference in mortality rate between the two groups at 28 days after discharge(P＞0.05).Conclusion Shen-Fu Injection can improve gastrointestinal dysfunction in patients with septic shock,alleviate gastrointestinal symptoms,suppress inflammatory responses,enhance gastrointestinal tissue perfusion,and can improve the short-term prognosis of pa-tients with septic shock to some extent.

With the promising overall efficacy of immune checkpoint inhibitors in non-small cell lung cancer(NSCLC)cohorts,neoadjuvant immunochemotherapy(NAIC)has emerged as a crucial clinical treatment for reducing surgical risks,improving pathological responses,and enhancing postoperative survival prognosis for patients with stage Ⅱ-ⅢB resectable NSCLC.However,the efficacy of NAIC and patient sur-vival outcomes vary between studies.Given the limitations of tissue-based programmed cell death-ligand 1(PD-L1)expression and tumor mutation burden(TMB)in dynamically monitoring the therapeutic efficacy of NAIC,alternative non-invasive potential biomarkers based on peripheral blood and imaging have gained widespread attention.This review highlights the advances in potential biomarkers,including in-flammatory derivatives,T-lymphocyte subsets,cytokines from peripheral blood,and radiomic features derived from CT images,for predict-ing the therapeutic efficacy and survival outcomes of NAIC in patients with NSCLC.

Objective The study aimed to investigate the effect of Shen-Fu injection on the clinical efficacy and prognosis of gas-trointestinal dysfunction in patients with septic shock.Methods Patients diagnosed with septic shock in the Department of Critical Care Medicine of the First Hospital of Lanzhou University from September 2021 to April 2024 were enrolled and divided into the Shen-Fu group and the conventional treatment group according to the treatment plan.The propensity score matching(PSM)was used for 1∶1 matc-hing.Clinical data of patients in both groups at enrollment,the main gastrointestinal symptoms(vomiting,diarrhea,abdominal disten-sion,abnormal bowel sounds,gastric retention),blood lactic acid(Lac),interleukin(IL)-6,procalcitonin(PCT),white blood cell(WBC),neutrophil percentage(NEUT％),the ratio of lactic acid to creatinine(Lac/SCr)before and 5days after treatment,and the mortality rate 28days after discharge were recorded.Results Compared with conventional treatment group(35.06％),the total effective rate(66.23％)of gastrointestinal efficacy in Shen-Fu group 5days after treatment was significantly higher(x2=14.964,P＜0.05).The levels of Lac,WBC and Lac/SCr in Shen-Fu group was higher than that in conventional treatment group(P＜0.05).There was no significant difference in IL-6,PCT and NEUT％(P＞0.05).Compared with pre-treatment,the levels of IL-6,Lac,Lac/SCr de-creased after 5days of treatment in Shen-Fu group(P＜0.05),while there was no significant difference in PCT,WBC and NEUT％(P＞0.05).There was no statistically significant difference in mortality rate between the two groups at 28 days after discharge(P＞0.05).Conclusion Shen-Fu Injection can improve gastrointestinal dysfunction in patients with septic shock,alleviate gastrointestinal symptoms,suppress inflammatory responses,enhance gastrointestinal tissue perfusion,and can improve the short-term prognosis of pa-tients with septic shock to some extent.

With the promising overall efficacy of immune checkpoint inhibitors in non-small cell lung cancer(NSCLC)cohorts,neoadjuvant immunochemotherapy(NAIC)has emerged as a crucial clinical treatment for reducing surgical risks,improving pathological responses,and enhancing postoperative survival prognosis for patients with stage Ⅱ-ⅢB resectable NSCLC.However,the efficacy of NAIC and patient sur-vival outcomes vary between studies.Given the limitations of tissue-based programmed cell death-ligand 1(PD-L1)expression and tumor mutation burden(TMB)in dynamically monitoring the therapeutic efficacy of NAIC,alternative non-invasive potential biomarkers based on peripheral blood and imaging have gained widespread attention.This review highlights the advances in potential biomarkers,including in-flammatory derivatives,T-lymphocyte subsets,cytokines from peripheral blood,and radiomic features derived from CT images,for predict-ing the therapeutic efficacy and survival outcomes of NAIC in patients with NSCLC.

Objective:To investigate the prevalence of norovirus and the correlation between norovirus infection and stool traits and clinical symptoms in children with acute gastroenteritis during 2021-2022.Method:A total of 2 195 anal swab samples were collected from cases of acute gastroenteritis in Beijing Children 's Hospital Affiliated to Capital Medical University from January 2021 to December 2022. PCR fluorescent probe assay was performed to detect norovirus，the clinical information and test results were performed by statistical analysis. Results:The detection rate of norovirus was 19.09%（419/2 195）in 2 195 children. The detection rates of male and female were 17.80%（244/1 371）and 21.24%（175/824），respectively，with statistically significant differences between genders（ χ2=3.945, P<0.05）. The positivity rate of noroviruses was higher in aged 1 month to 3 years［29.09%（64/220）~40.69%（94/231）］，especially in 1 year［40.69%（94/231）］. The norovirus detection rate ranged from 2.44%（2/82）to 35.84%（62/173）in different months，with a high detection rate between January and March，higher in the winter and spring［28.36%（150/529），21.07%（146/693）］，showing a clear seasonal distribution.Clinical symptoms of both vomiting and diarrhea were significantly more common among norovirus positive than negative children，the difference was statistically significant（ χ2=57.29, P<0.05）. Conclusion:In the high incidence season of winter and spring，for infants and young children aged 1 month to 3 years with diarrhea accompanied by vomiting symptoms，especially those aged 1 year，it is recommended to undergo norovirus related testing in time. Early treatment and isolation measures should be taken for diagnosed children to reduce cross infection and prevent outbreaks.

Objective:To examine the efficacy and experience of staged and segmented two hybrid surgeries for total repair of Debakey type Ⅰ aortic dissection (TIAD).Methods:This study was a retrospective case series. The clinic data of 10 patients with acute TIAD who were admitted to the Department of Cardiac Surgery, Second Hospital of Lanzhou University or the First People′s Hospital of Lanzhou, between January 2016 and August 2022, were retrospectively studied. Ten patients underwent hybrid surgeries in two hospitalizations (stages), including 7 males and 3 females with an age of (60±7) years (range: 49 to 71 years). In stage 1, the first type Ⅱ hybrid arch repair was performed to treat the ascending, total arch, and descending thoracic aorta for acute TIAD without circulatory arrest. In stage 2, the second hybrid surgery including infrarenal abdominal aorta replacement, visceral arteries bypass and endovascular thoracoabdominal aortic repair was performed to treat residual thoracoabdominal aortic dissection after the first hybrid operation (segmented). Basic data, preoperative concomitant diseases, high-risk factors, surgical approaches and postoperative complications of all important organs, as well as CT imaging were analyzed.Results:There was no death in the 20 hybrid surgical procedures. In stage 1 type Ⅱ hybrid surgery, 4 cases underwent reconstruction of the aortic sinutubular junction, while Bentall and David surgery was performed for 3 cases, respectively. A patient received coronary artery bypass grafting. Then all patients were sequentially treated with arch debranching and thoracic aortic endovascular repair. Postoperative complications included renal insufficiency (4/10), hemofiltration (1/10), hypoxemia (4/10), neurologic event (1/10) and type Ⅱ endoleak (1/10). Complete false lumen thrombosis occurred in 9/10 of the patients. All complications recovered successfully at discharge and the average hospital stay was (21±4) days (range: 16 to 28 days) in the first hospitalization. At stage 2, the second hybrid surgery was successfully performed in all patients. No paraplegia, hepatic or renal insufficiency, or endoleak occurred. However, branch graft embolism of the left renal artery was found in one patient 3 days after laparotomy, as well as of superior mesenteric artery in another. Superior mesenteric artery occlusion was successfully treated by endovascular recanalization. Complete false lumen thrombosis occurred in all patients. Although all patients had different degrees of intestinal dysfunction, they were gradually relieved at discharge, and the average hospital stay was (19±2)days (range:16 to 21 days) in the second hospitalization. During follow-up, CT angiography showed aortic remodeling in all patients.Conclusion:Staged and segmented two hybrid surgeries are safe and feasible for total repair of Debakey type Ⅰ aortic dissection and are associated with acceptable early and midterm outcomes.

Objective:To examine the efficacy and experience of staged and segmented two hybrid surgeries for total repair of Debakey type Ⅰ aortic dissection (TIAD).Methods:This study was a retrospective case series. The clinic data of 10 patients with acute TIAD who were admitted to the Department of Cardiac Surgery, Second Hospital of Lanzhou University or the First People′s Hospital of Lanzhou, between January 2016 and August 2022, were retrospectively studied. Ten patients underwent hybrid surgeries in two hospitalizations (stages), including 7 males and 3 females with an age of (60±7) years (range: 49 to 71 years). In stage 1, the first type Ⅱ hybrid arch repair was performed to treat the ascending, total arch, and descending thoracic aorta for acute TIAD without circulatory arrest. In stage 2, the second hybrid surgery including infrarenal abdominal aorta replacement, visceral arteries bypass and endovascular thoracoabdominal aortic repair was performed to treat residual thoracoabdominal aortic dissection after the first hybrid operation (segmented). Basic data, preoperative concomitant diseases, high-risk factors, surgical approaches and postoperative complications of all important organs, as well as CT imaging were analyzed.Results:There was no death in the 20 hybrid surgical procedures. In stage 1 type Ⅱ hybrid surgery, 4 cases underwent reconstruction of the aortic sinutubular junction, while Bentall and David surgery was performed for 3 cases, respectively. A patient received coronary artery bypass grafting. Then all patients were sequentially treated with arch debranching and thoracic aortic endovascular repair. Postoperative complications included renal insufficiency (4/10), hemofiltration (1/10), hypoxemia (4/10), neurologic event (1/10) and type Ⅱ endoleak (1/10). Complete false lumen thrombosis occurred in 9/10 of the patients. All complications recovered successfully at discharge and the average hospital stay was (21±4) days (range: 16 to 28 days) in the first hospitalization. At stage 2, the second hybrid surgery was successfully performed in all patients. No paraplegia, hepatic or renal insufficiency, or endoleak occurred. However, branch graft embolism of the left renal artery was found in one patient 3 days after laparotomy, as well as of superior mesenteric artery in another. Superior mesenteric artery occlusion was successfully treated by endovascular recanalization. Complete false lumen thrombosis occurred in all patients. Although all patients had different degrees of intestinal dysfunction, they were gradually relieved at discharge, and the average hospital stay was (19±2)days (range:16 to 21 days) in the second hospitalization. During follow-up, CT angiography showed aortic remodeling in all patients.Conclusion:Staged and segmented two hybrid surgeries are safe and feasible for total repair of Debakey type Ⅰ aortic dissection and are associated with acceptable early and midterm outcomes.

Humans ; COVID-19/genetics* ; SARS-CoV-2/genetics* ; Clustered Regularly Interspaced Short Palindromic Repeats/genetics* ; CRISPR-Cas Systems/genetics* ; RNA, Viral/genetics*

Objective:To explore the clinical manifestations and genetic characteristics of Wolf-Hirschhorn syndrome (WHS) to improve the ability of diagnosis and differential diagnosis of the disease.Methods:The clinical features and auxiliary examinations and treatment of a proband with WHS caused by microdeletion of 4p16.3 segment who admitted to the Third Affiliated Hospital of Zhengzhou University in December 2021 were recorded, and whole exome sequencing (WES) of the family was performed. The prognosis was followed up.Results:The female proband, 11 months old, presented with convulsions at the age of 8 months, with the characteristics of heat sensitivity and cluster seizures, and her identical twin sister had a similar medical history. Physical examination found malnutrition, retarded development, special face, prominent forehead, wide nasal bridge, small jaw, precordial murmur and grade 3/6 murmur in the whole period, hyperactivity of P2, and low limb muscle tone. The whole exon and copy number variation (CNV) test of the family revealed that the proband had a 1.99 Mb heterozygous deletion in the chromosome 4p16.3 segment, including WHSC1 (NSD2), WHSC2 (NEFLA) and other genes. Copy number variation sequencing (CNV-Seq) of the proband and her sister showed 1.97 and 1.92 Mb heterozygous deletion of chromosome 4p16.3, respectively. Genealogical analysis by quantitative polymerase chain reaction revealed that the CNV was de novo, and it was determined to be a pathogenic variant according to the American College of Medical Genetics and Genomics guidelines. The proband took sodium valproate orally, and her sister took oral sodium valproate, zonisamide, and levetiracetam successively, and at the same time they received family rehabilitation training. The age at the last follow-up was 1 year and 8 months. Neither of them had convulsions again in the past 3 months, but the developmental delay was obvious. Conclusion:WHS patients may present with growth retardation, epilepsy, Greek warrior helmet-like special face, and congenital heart disease, and may have microdeletions in the chromosome 4p16.3 segment.

With the continuous in-depth study of minimally invasive cardiac surgery(MICS), minimally invasive cardiac surgery in children has also been developed in this period, but there is still a certain gap compared with adults. Because of the large difference in body size and the low tolerance of surgery in children, minimally invasive cardiac surgery in children still has a short board on complex cardiac diseases. This article reviews several commonly used minimally invasive techniques: (1) small incision cardiac surgery; (2) thoracoscopic and robot-assisted cardiac surgery; (3) minimally invasive cardiopulmonary bypass(MiECC) and cardiac surgery to avoid cardiopulmonary bypass; (4) hybrid surgery and enhanced cardiac rehabilitation surgery(ERACS) in pediatric cardiac surgery and their application and research progress.