Chronic thromboembolic pulmonary hypertension(CTEPH)is a form of pulmonary hypertension caused by unresolved thrombi and chronic embolization in the pulmonary arteries.In recent years,multi-omics technologies have provided multidimensional insights into CTEPH.Single-cell transcriptomics has identified key pathogenic cell subsets and related mechanisms;Genomics has revealed susceptibility genes associated with coagulation;Proteomics has uncovered differentially expressed proteins closely linked to vascular remodeling;And metabolomics has characterized metabolic reprogramming features and potential sub-typing biomarkers.This review summarizes re-cent advances in these omics fields and discusses their value and prospects in mechanistic exploration,biomarker discovery,and personalized therapeutic strategies.

Objective:To evaluate the diagnostic value of hydrogen sulfide breath test(SBT) for small intestinal bacterial overgrowth (SIBO).Methods:College students were enrolled to complete gastrointestinal symptom scale, food frequency questionnaire, lactulose hydrogen- methane breath test (LHMBT) and SBT. Based on the correlation between hydrogen sulfide(H 2S) and hydrogen or methane gas,the receiver operating characteristic (ROC) curve of H 2S was drawn and diagnostic criteria of SBT was defined. Results:A total of 300 subjects including 84 males and 216 females with age 17-32 (21.6±2.4) years were enrolled from April 2019 to December 2019 and divided into two groups.Two hundred and three patients reported SIBO discomforts with 99 (48.8%) LHMBT positive, while 38 (39.2%) were LHMBT positive in 97 health controls. Rise of H 2S at 90 min was positively related with that of hydrogen ( r=0.516, P<0.01), and H 2S levels at 90 min were positively correlated with methane ( r=0.632, P<0.01). A rise in H 2S of ≥25.0 ppb or H 2S levels ≥62.5 ppb at 90 min during lactulose breath test was considered positive for SIBO, that sensitivity, specificity and accuracy were 66.4%,79.1% and 73.3% respectively. H 2S levels were significantly related to the amount of Vitamin B 12 intake ( P=0.011). H 2S-positive subjects exhibited a constipation-predominant pattern. Conclusion:SBT is consistent with LHMBT, especially in constipation-predominant patients, which may provide a reference to the diagnosis of SIBO.

Objective    To compare the clinical effects of segmentectomy and lobectomy for ≤2 cm lung adenocarcinoma with micropapillary and solid subtype negative by intraoperative frozen sections. Methods    The patients with adenocarcinoma who received segmentectomy or lobectomy in multicenter from June 2020 to March 2021 were included. They were divided into two groups according to a random number table, including a segmentectomy group (n=119, 44 males and 75 females with an average age of 56.6±8.9 years) and a lobectomy group (n=115, 43 males and 72 females with an average of 56.2±9.5 years). The clinical data of the patients were analyzed. Results    There was no significant difference in the baseline data between the two groups (P>0.05). No perioperative death was found. There was no statistical difference in the operation time (111.2±30.0 min vs. 107.3±34.3 min), blood loss (54.2±83.5 mL vs. 40.0±16.4 mL), drainage duration (2.8±0.6 d vs. 2.6±0.6 d), hospital stay time (3.9±2.3 d vs. 3.7±1.1 d) or pathology staging (P>0.05) between the two groups. The postoperative pulmonary function analysis revealed that the mean decreased values of forced vital capacity and forced expiratory volume in one second percent predicted in the segmentectomy group were significantly better than those in the lobectomy group (0.2±0.3 L vs. 0.4±0.3 L, P=0.005; 0.3%±8.1% vs. 2.9%±7.4%, P=0.041). Conclusion    Segmentectomy is effective in protecting lungs function, which is expected to improve life quality of patients.

Objective Evaluation of self-control suspension under the double hook system used to xiphoid thoracoscope fully the effect of thymectomy.Methods There were 17 cases of thymic adenoma diagnosed before surgery in November to December 2016,including 7 males and 10 females,aged(57 ± 10).The total thymomectomy was performed with a double hook method with a double hook procedure.Results All the 17 patients had smooth operation,and no clear hook related complications were observed after the operation.The operation was convenient and the thymus was completely removed.Conclusion It is worth populating that the double pull hook method is convenient and safe to remove the whole thymus gland.

Background and objective As computed tomography (CT) screening for lung cancer becomes more common in China, so too does detection of pulmonary ground-glass nodules (GGNs). Although anumber of national or international guidelines about pulmonary GGNs have been published,most of these guidelines are produced by respiratory, oncology or radiology physicians, who might not fully understand the progress of modern minimal invasive thoracic surgery, and these current guidelines may overlook or underestimate the value of thoracic surgery in the management of pulmonary GGNs. In addition, the management for pre-invasive adenocarcinoma is still controversial. Based onthe available literature and experience from Shanghai Pulmonary Hospital, we composed this consensus about diagnosis and treatment of pulmonary GGNs. For lesions which are considered as adenocarcinoma in situ, chest thin layer CT scan follow-up is recommended and resection can only be adopt in some specific cases and excision should not exceed single segment resection. For lesions which are considered as minimal invasive adenocarcinoma, limited pulmonary resection or lobectomy is recommended. For lesions which are considered as early stage invasive adenocarcinoma, pulmonary resection is recommend and optimal surgical methods depend on whether ground glass component exist, location, volume and number of the lesions and physical status of patients. Principle of management of multiple pulmonary nodules is that primary lesions should be handled with priority, with secondary lesions taking into account.
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Adenocarcinoma ; diagnosis ; diagnostic imaging ; surgery ; Adenocarcinoma of Lung ; China ; Consensus ; Hospitals ; Humans ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Physicians ; psychology ; Positron Emission Tomography Computed Tomography ; Practice Guidelines as Topic ; Retrospective Studies ; Solitary Pulmonary Nodule ; diagnosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

Objective: To investigate hepatitis C virus(HCV)genotyping and the serum HCV-RNA concentration in patients infected with different HCV genotypes and to provide information for evaluation of disease condition and anti-viral treatment efficacy. Methods: A total of 60 anti-HCV positive serum samples were collected before antiviral treatment. RT-PCR was performed for the 5′ non-cording region and was followed by nucleotide sequencing for HCV genotyping. Meanwhile, serum HCV-RNA concentration was detected by quantitative PCR. SPSS21.0 and Graphpad Prism 5.0 software were used for data analysis. Analysis of variance (ANOVA) was used for comparison among multi-groups and the t-test was used for comparison between two groups. Results: The frequencies of HCV genotypes 1b, 3a, 1a and 2a were 48.3% (29/60), 23.3% (14/60), 16.7% (10/60) and 10% (6/60), respectively. And, there is one subtype 2c was detected in this study. The mean serum viral concentration with standard deviation of HCV in genotype 1a, 1b, 2a, and 3 a were 5.46±1.19, 6.22±0.78, 5.47±0.65, and 5.38±0.98 log₁₀ (IU/ml) respectively. Conclusions The infection rate of HCV genotype 1 was significantly higher than that of genotype 2 and 3 (P<0.01). The statistical analysis showed the serum HCV-RNA concentration in patients with subtype 1b was significantly higher than that of the subtype group 1 a, 2 a, and 3 a (P<0.05). The study of the relationship between HCV genotypes and the serum HCV-RNA concentration may contribute to anti-viral treatment prescription for hepatitis C patients.

Objective To optimize and simplify the survey method of Oncomelania hupensis snail in marshland endemic re?gion of schistosomiasis and increase the precision,efficiency and economy of the snail survey. Methods A quadrate experimen?tal field was selected as the subject of 50 m×50 m size in Chayegang marshland near Henghu farm in the Poyang Lake region and a whole?covered method was adopted to survey the snails. The simple random sampling,systematic sampling and stratified ran?dom sampling methods were applied to calculate the minimum sample size,relative sampling error and absolute sampling error. Results The minimum sample sizes of the simple random sampling,systematic sampling and stratified random sampling meth?ods were 300,300 and 225,respectively. The relative sampling errors of three methods were all less than 15%. The absolute sampling errors were 0.221 7,0.302 4 and 0.047 8,respectively. Conclusion The spatial stratified sampling with altitude as the stratum variable is an efficient approach of lower cost and higher precision for the snail survey.

OBJECTIVE:To optimize water extraction technology of Shenqi yiqi capsules. METHODS:The water extraction technology of Shenqi yiqi capsules was optimized by L9(34)orthogonal test with amount of water added,decoction times and decoc-tion time as factors using the extraction rate of astragaloside,calyosin-7-O-β-D-glycoside,icariin and bergenin as index,and the verification test was made. RESULTS:The best extraction technology was as follows as 8-fold water,decocting for 3 times,2 h each time;comprehensive score of 3 batches of samples in validation test were 98.95,99.71 and 99.98(RSD<2%,n=3). CON-CLUSIONS:The water extraction technology optimized by multi-index comprehensive score-orthogonal test is stable,scientific and reasonable.

In the investigation of asymmetric catalytic hydrogenation reaction, (Z)-methyl-2-acetamidocinnamate is often used as a standard substrate to assess the chiral catalysts. However, its previous syntheses suffered from low yield, relying on column chromatography for isolation. Herein, (Z)-methyl-2-acetamidocinnamate was obtained with 68. 5% isolation yield via simple operations such as wash and extraction using dicyclohexylcarbodiimide(DCC)as dehydrant and 4-dimethylaminopyridine(DMAP)as catalyst in the last synthetic step.

Objective Severe bronchial stricture due to endobronchial tuberculosis is often accompanied by complex complication,such as obstructiv pneumonia,destroyed lung and bronchiectasis.Its treatment is very diffucult.The present report is to investigate and analyze the indication and efficacy of surgical treatment of bronchial stricture due to severe endobronchial tuberculosis.Methods Reviewed the clinico-pathological records documenting the surgical outcomes in 81 bronchial stricture due to severe endobronchial tuberculosis who underwent lobectomy or pneumonectomy enrolled in our hospital between January 1990 and December 2010.There were 29 male and 52 female.Mean age was(36 ± 12) years (ranged 16-66 years).The three most common reasons of surgery were bronchial stricture accompanied by pulmonary atelectasis,destroyed lung and bronchiectasis(76 cases,93.8％).79 cases had elective operation,whereas one patients required emergency surgery.Pueumonectomy in 51,lobectomy in 16,sleeve resection in 11,segmental resection in 2,and exploratory thoracotomy in 1.If frozen pathological examination showed that endobronchial tuberculosis remained in the bronchial stump,it was covered with muscle flaps,including intercostal muscle flap in 6 cases,latissimus dorsi muscle flap in 5 cases,serratus anterior muscle flap in 5 cases.The mean operative time was 3.2 h (range between 2 h and 5.5 h) and the blood loss averaged 546 ml (range between 100ml and 4 000 ml).The post operative hospital stay averaged(12 ±8)days.Results No intraoperative or early postoperative death occurred.Nine patients developed complications,including BPF in 2,pulmonary infection in 2,empyema in 1,hemorragic shock in 1,hemothorax in 1,incision infection in 1,chylothorax in 1.All 9 cases recovered well after treatment.Pathological examination showed that tuberculosis bronchial remained in the brinchial stump in 13 cases.Neither BPF nor empyema occurred in all the 13 cases.Multivariate analysis revealed that destroyed lung was significant risk factor of postoperative complication.There were 3 late deaths.Five year survival rate was 96.2％.Conclusion Surgical treatment is still the recommeded treatment modatity for bronchial stricture caused by endobronchial tuberculosis due to its excellent results.It should be performed in time when the drug and intraluninal treatment were no effect for avoiding of being progeressed into destroyed lung.