Chronic post-surgical pain (CPSP) is a common long-term complication following lung surgery. Its high incidence significantly impacts patients’ quality of life and functional recovery, and imposes a substantial socioeconomic burden. This consensus aims to systematically establish a standardized integrated Chinese and Western medicine diagnostic and treatment framework for chronic post-lung surgery pain (CPLSP). Based on the latest domestic and international evidence-based medical research and multidisciplinary clinical experience, the working group comprehensively elaborates on core issues regarding CPLSP, including its definition, epidemiology, pathogenesis, clinical assessment, Western medical treatment, traditional Chinese medicine (TCM) treatment, and integrated strategies. The consensus emphasizes a patient-centered approach, adhering to the principles of multimodality, individualization, and stepwise management, highlighting the synergistic advantages of integrating Chinese and Western medicine throughout the entire perioperative management cycle encompassing "perioperative anti-inflammation, acute analgesia, and chronic rehabilitation." Through systematic literature retrieval and evidence integration, a total of 9 core recommendations were established to provide scientifically sound and clinically practical guidance.

Objective:To investigate the effectiveness of new cryoprotective agents in preserving and transplanting human adipose tissue.Methods:The adipose tissue samples were obtained from healthy adult females who underwent liposuction at the Department of Plastic Surgery of Peking University Third Hospital from January to March 2022. The adipose tissue samples were centrifuged and then randomly divided into 9 groups. These groups were cryopreserved in liquid nitrogen using different cryoprotective agents [group A, group B, and dimethyl sulfoxide (DMSO) group] and cryopreservation times (1-month, 2-month, and 3-month groups), respectively. The cryoprotective agent formulation in group A was dextrose glycoside 40 (DEX), amino acids, vitamins, and inorganic salts. In group B, the formulation included DMSO and DEX. The ratio of cryoprotective agent in the DMSO group was 10% DMSO, 20% fetal bovine serum (FBS), and 70% DMEM-12. For cryopreservation, 5 ml cryogenic tubes were used with a fat to cryoprotective agent ratio of 3∶2, and each group contains 6 tubes for cryopreservation. After thawing the adipose tissue, HE staining was used to observe the histological morphology. Immunohistochemical staining was employed for the quantitative analysis of lipid droplet-encapsulated protein (Perilipin), and the Perilipin positivity rate was calculated by the ratio of the number of positive cells to the total number of cells. Adipocyte viability was assessed using the CCK-8 method. Thirty-eight healthy, clean nude mice were selected and divided into 3 groups of 12 mice each according to the use of different cryoprotective agents (groups A, B, and DMSO), while the other 2 mice were used as the day 0 control group. The mean fat freezing duration for all groups was 3 months. After nude mice were anesthetized intraperitoneally, 0.9 ml of thawed cryopreserved fat was injected into the dorsum bilaterally. The rate of adipose tissue retention was calculated by MRI scanning and three-dimensional software at 1, 2, and 3 months after transplantation, and compared between the groups. The fat grafts were explanted from the mice after they were sacrificed, and then subjected to histological morphology and quantitative analysis of Perilipin by using HE staining and immunohistochemical staining. GraphPad Prism 8.0 software was used for statistical analysis of the data. The data that conformed to a normal distribution were expressed as Mean ± SD. The overall comparison between multiple groups used analysis of variance for repeated measures. The comparison of data between groups at the same time point used Tukey’s multiple comparison test.Results:The morphology of adipose tissue in different cryoprotective agent groups closely resembled that of normal fresh adipose tissue after being cryopreserved in liquid nitrogen for 1-3 months. The difference in the proportion of Perilipin-stained positive cells in each group was not statistically significant ( P>0.05). The CCK-8 method indicated that the effect of the DMSO group was superior to groups A and B at 1 and 3 months of cryopreservation ( P<0.01), and that the DMSO group and group B were superior to group A at 2 months of cryopreservation ( P<0.01). In the animal experiments, there was no statistically significant difference between the groups in the volume retention rate 1-3 months after cryopreserved fat transplantation ( P>0.05). Additionally, the adipose tissues in each group exhibited varying degrees of localized necrosis accompanied by an inflammatory reaction 1-3 months after transplantation. There was no statistically significant difference in the Perilipin staining positivity between the groups ( P>0.05). Conclusion:The use of new cryoprotective agents for cryopreserving adipose tissue does not show a significant difference compared to the traditional cryoprotective agent. However, it is theoretically safer as it avoids the potential toxic effects of using DMSO or FBS on the human body.

Objective To observe the effect of shoulder-high head back-up position on airway ob-struction and hypoxia during fiberoptic bronchoscopy under non-intubated general anesthesia.Methods A total of 170 patients undergoing painless fiberoptic bronchoscopy,97 males and 73 females,aged 18-64 years,BMI 18.5-28.0 kg/m2,ASA physical status Ⅰ-Ⅲ,were randomly divided into two groups by ran-dom number method:observation group(group D,n=84)and control group(group C,n=83).Group D adopted the shoulder-high head back-up position,and group C adopted the supine position.All the pa-tients received intravenous general anesthesia of propfol combined with sufentanil,and were oxygenated via an ordinary endoscopic mask with an oxygen flow rate of 8-10 L/min.Fiberoptic bronchoscopy was per-formed when the modified observer assessment of alertness and sedation(MOAA/S)score was≤1 point.The number of cases in which hypoxia occurred and corrective measures were taken were recorded.The changes of HR,SBP,DBP,and SpO2 before induction of anesthesia(T1),1 minute after induction of an-esthesia(T2),endotracheal surface anesthesia(T3),at the time of examination(T4),and at the end of the examination(T5)were recorded.The degree of obstruction of the retropalatal space and retroglossal space at T2 were recorded.The level of glottic exposure and operating comfort of the endoscopist were recor-ded during the examination,and the incidence of postoperative neck discomfort,postoperative headache,postoperative dizziness,and nausea and vomiting were recorded.Results Compared with group C,the in-cidence of intraoperative moderate hypoxia,severe hypoxia,jaw support,and assisted ventilation was signifi-cantly decreased in group D(P＜0.05).Compared with T1,the HR were significantly increased at T3 and T4(P＜0.05),SBP and DBP were significantly decreased at T2,T4,and T5(P＜0.05),SpO2 was sig-nificantly increased at T2 and decreased at T4 in the two groups(P＜0.05),and SpO2 in group C was sig-nificantly decreased at T3(P＜0.05).Compared with group C,SpO2 was significantly increased at T4,the incidence of non-obstruction in the retrolingual space was significantly increased,and the incidence of com-plete obstruction in the retrolingual space was significantly decreased at T2,and the incidence of good glottic exposure was significantly increased,the incidence of poor glottic exposure was significantly decreased,and the incidence of good operating comfort of the endoscopist was significantly increased in group D(P＜0.05).There was no significant difference in the incidence of postoperative adverse events between the two groups.Conclusion Shoulder-high head back-up position can alleviate airway obstruction and reduce the incidence of hypoxia during fiberoptic bronchoscopy under non-intubated general anesthesia.

Objective To explore the clinical and imaging features of phosphaturic mesenchymal tumor(PMT).Methods The clinical presentations,laboratory examinations,and imaging manifestations of seven patients with PMT diagnosed by surgery and pathology were analyzed retrospectively.Results Among the 7 patients,four patients had clinical presentations of long-term fatigue and bone pain.All patients showed preoperative blood phosphorus reduction in varying degrees.X-ray examination showed systemic osteomalacia and osteoporosis,accompanied by multiple pathological fractures.On CT,the primary tumor appeared as a soft tissue density mass or a ground glass high-density nodule with irregular calcification and local bone destruction.MRI showed long T1,long T2 signal intensity,and irregular low signal foci were scattered in the T2WI fat-suppressed sequence.The enhanced scans showed moderate to significant inhomogeneous enhancement.One patient who underwent 18F-FDG PET/CT and two patients who underwent 18F-ALF-NOTA-Octreotide(18F-OC)PET/CT examinations showed varying degrees of radioactive concentration in the lesions.Conclusion The clinical presentations and laboratory examinations of patients with PMT have certain characteristics.Systemic osteomalacia with pseudofracture line,calcification matrix within the tumor,and significant inhomogeneous enhancement of the lesion are the key imaging features for diagnosing PMT.18F-OC PET/CT examination plays a crucial role in the systemic localization diagnosis of tumors.

Objective:To reveal the diurnal variation characteristics of the exercise adaptability of cardiac function in healthy men of different ages by the analysis of echocardiographic parameter changes before and after exercise intervention using the left ventricular pressure-strain loop techniques.Methods:A prospective control design was used to collect 193 healthy male volunteers from October 2022 to July 2023 in Tangdu Hospital, 101 in the young group [(26±5) years old], and 92 in the middle-aged group [(50±4) years old]. The heart rate, blood pressure and routine echocardiographic parameters were collected at rest and after exercise stress (3-minute step test) at 7∶00 a.m.and 10∶00 p.m., respectively. The heart rate, blood pressure cardiac output, and echocardiographic parameters [anteroposterior diameter of left atrium (LAD), ratio of peak early diastolic flow velocity to late diastolic peak flow velocity of mitral valve (E/A), left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVEDS)] were then determined. The parameters of myocardial work including left ventricular longitudinal strain (GLS), global work index (GWI), global work efficiency (GWE), global constructive work (GCW) and global wasted work (GWW) were obtained by left ventricular pressure-strain loop technique. The differences of the parameters above between before and after step test, morning and night, young group and middle-aged group were compared.Results:The heart rate, blood pressure and cardiac output of young and middle-aged healthy men increased significantly in the morning and night step test (all P<0.05), GLS, GWI, GCW and GWW were significantly higher than those in resting state (all P<0.05), and GWE was significantly lower than that in resting state ( P<0.05). The change rates of heart rate, cardiac output, GLS, GWI and GCW in the early morning were significantly higher than those at night (all P<0.05), while the change rates of blood pressure and GWE in each group were significantly lower than those at night ( P<0.05). The change rates of heart rate, systolic blood pressure, GLS and GWI in the middle-aged group were significantly higher than those in the young group in the morning and night (all P<0.05), while the change rate of diastolic blood pressure at night was significantly higher than that in the young group ( P<0.05), but there was no significant difference in the morning ( P>0.05). Conclusions:The cardiac adaptability of healthy men has obvious circadian rhythm, characterized by being of low in the morning and high in the evening. Age mainly affects the cardiac adaptability in the morning. The response to low-intensity load stimulation increases with aging, indicating the decrease of morning cardiac adaptability.

Objective:To investigate the effectiveness of new cryoprotective agents in preserving and transplanting human adipose tissue.Methods:The adipose tissue samples were obtained from healthy adult females who underwent liposuction at the Department of Plastic Surgery of Peking University Third Hospital from January to March 2022. The adipose tissue samples were centrifuged and then randomly divided into 9 groups. These groups were cryopreserved in liquid nitrogen using different cryoprotective agents [group A, group B, and dimethyl sulfoxide (DMSO) group] and cryopreservation times (1-month, 2-month, and 3-month groups), respectively. The cryoprotective agent formulation in group A was dextrose glycoside 40 (DEX), amino acids, vitamins, and inorganic salts. In group B, the formulation included DMSO and DEX. The ratio of cryoprotective agent in the DMSO group was 10% DMSO, 20% fetal bovine serum (FBS), and 70% DMEM-12. For cryopreservation, 5 ml cryogenic tubes were used with a fat to cryoprotective agent ratio of 3∶2, and each group contains 6 tubes for cryopreservation. After thawing the adipose tissue, HE staining was used to observe the histological morphology. Immunohistochemical staining was employed for the quantitative analysis of lipid droplet-encapsulated protein (Perilipin), and the Perilipin positivity rate was calculated by the ratio of the number of positive cells to the total number of cells. Adipocyte viability was assessed using the CCK-8 method. Thirty-eight healthy, clean nude mice were selected and divided into 3 groups of 12 mice each according to the use of different cryoprotective agents (groups A, B, and DMSO), while the other 2 mice were used as the day 0 control group. The mean fat freezing duration for all groups was 3 months. After nude mice were anesthetized intraperitoneally, 0.9 ml of thawed cryopreserved fat was injected into the dorsum bilaterally. The rate of adipose tissue retention was calculated by MRI scanning and three-dimensional software at 1, 2, and 3 months after transplantation, and compared between the groups. The fat grafts were explanted from the mice after they were sacrificed, and then subjected to histological morphology and quantitative analysis of Perilipin by using HE staining and immunohistochemical staining. GraphPad Prism 8.0 software was used for statistical analysis of the data. The data that conformed to a normal distribution were expressed as Mean ± SD. The overall comparison between multiple groups used analysis of variance for repeated measures. The comparison of data between groups at the same time point used Tukey’s multiple comparison test.Results:The morphology of adipose tissue in different cryoprotective agent groups closely resembled that of normal fresh adipose tissue after being cryopreserved in liquid nitrogen for 1-3 months. The difference in the proportion of Perilipin-stained positive cells in each group was not statistically significant ( P>0.05). The CCK-8 method indicated that the effect of the DMSO group was superior to groups A and B at 1 and 3 months of cryopreservation ( P<0.01), and that the DMSO group and group B were superior to group A at 2 months of cryopreservation ( P<0.01). In the animal experiments, there was no statistically significant difference between the groups in the volume retention rate 1-3 months after cryopreserved fat transplantation ( P>0.05). Additionally, the adipose tissues in each group exhibited varying degrees of localized necrosis accompanied by an inflammatory reaction 1-3 months after transplantation. There was no statistically significant difference in the Perilipin staining positivity between the groups ( P>0.05). Conclusion:The use of new cryoprotective agents for cryopreserving adipose tissue does not show a significant difference compared to the traditional cryoprotective agent. However, it is theoretically safer as it avoids the potential toxic effects of using DMSO or FBS on the human body.

Objective:To provide references for the vestibular function stability training of military pilots by evaluating the stability of vestibular function of military pilots.Methods:An electric swivel chair was used to train the vestibular function stability of military pilots. According to the order of admission, they were divided into 21-30 years old, 31-40 years old, 41-50 years old and ≥51 years old group, with 30 pilots in each group. The changes of excellent rate, good rate, qualified rate, unqualified rate and tolerance time of the stability of vestibular function by training were compared among different age groups, and the correlation between age and tolerance time was analyzed.Results:There were significant differences of unqualified rate in pilots aged 31-40 and ≥51 years group before and after training ( χ2=4.32, 4.80, Ρ=0.038, 0.028). The failure rate after training was lower than that before training, with a significant difference ( χ2=13.02, P<0.001). The total tolerance time was higher than that before training, and the difference was statistically significant ( t=17.61, P<0.001). The stability tolerance time of pilots in different age groups after vestibular function training were increased compared with that before training, and the differences were statistically significant ( t=6.50, 8.82, 9.48, 13.56, all P<0.001). The stability of vestibular function of military pilots gradually declined with the increase of age, and there was a negative correlation between age and training tolerance time ( r=-0.38, P<0.001). Conclusions:The training of electric swivel chair can improve the vestibular function stability of military pilots, increase the tolerance time, and enhance the tolerance ability of military pilots when vestibular function is stimulated.

Objective:To provide references for the vestibular function stability training of military pilots by evaluating the stability of vestibular function of military pilots.Methods:An electric swivel chair was used to train the vestibular function stability of military pilots. According to the order of admission, they were divided into 21-30 years old, 31-40 years old, 41-50 years old and ≥51 years old group, with 30 pilots in each group. The changes of excellent rate, good rate, qualified rate, unqualified rate and tolerance time of the stability of vestibular function by training were compared among different age groups, and the correlation between age and tolerance time was analyzed.Results:There were significant differences of unqualified rate in pilots aged 31-40 and ≥51 years group before and after training ( χ2=4.32, 4.80, Ρ=0.038, 0.028). The failure rate after training was lower than that before training, with a significant difference ( χ2=13.02, P<0.001). The total tolerance time was higher than that before training, and the difference was statistically significant ( t=17.61, P<0.001). The stability tolerance time of pilots in different age groups after vestibular function training were increased compared with that before training, and the differences were statistically significant ( t=6.50, 8.82, 9.48, 13.56, all P<0.001). The stability of vestibular function of military pilots gradually declined with the increase of age, and there was a negative correlation between age and training tolerance time ( r=-0.38, P<0.001). Conclusions:The training of electric swivel chair can improve the vestibular function stability of military pilots, increase the tolerance time, and enhance the tolerance ability of military pilots when vestibular function is stimulated.

Objective:To explore the relationship among maximal oxygen uptake (VO 2max), heart rate recovery after exercise (HRR) and anti-G ability of fighter pilots. Methods:A total of 90 fighter pilots were selected by cluster sampling method, and the +G z tolerance that devoted by anti-G staining manoeuvre performing was predicted by anti-G and anti-hypoxia ability detector and G tolerance empirical formula. The values of VO 2max and HRR were collected under 25 W/min power increasing rate scheme. According to the level of VO 2max, pilots were divided into 3 groups: low level (the bottom third), intermediate level (the middle third) and high level (the top third). The differences of HRR value and +G z tolerance increment among the first, second and third minutes after exercise were compared among the pilots of different level of VO 2max. The correlation among the values of HRR, VO 2max and +G z tolerance increment were analyzed. Results:There were significant differences in the values of HRR and +G z tolerance increment at the second and the third minutes of exercise among the pilots with different VO 2max levels in 3 groups ( F=7.65, 10.64, 10.28, all P≤0.001). There was no obvious correlation between the values of HRR, VO 2max and +G z tolerance increment at the first minute after exercise ( r=0.020, -0.017, P=0.852, 0.871). The value of HRR at the second minute after exercise was positively correlated with VO 2max ( r=0.288, P=0.006), but not obviously with the +G z tolerance increment ( r=-0.017, P=0.150). The value of HRR value at the third minute was positively correlated with the increase of VO 2max and +G z tolerance increment ( r=0.433, 0.240, P<0.001, =0.023). VO 2max was positively correlated with the increase of +G z tolerance increment ( r=0.436, P<0.001). Conclusions:The increase of pilots′ VO 2max is conducive to the improvement of anti-G ability. The value of HRR at the third minute after exercise can be used as a sensitive monitoring index to predict pilot′s G-tolerance.

Objective:To explore the quantitative effect of smoking on pilots′ physical fitness.Methods:According to smoking index, 215 fighter pilots were chosen as subjects and divided into non-smoking group (143 cases), low smoking-index group (23 cases), moderate smoking-index group (20 cases) and high smoking-index group (29 cases). Subjects were asked to rest on the power bicycle for 3 min, then start warm up at a speed of 60 r/min (no-load, low-level exercise at 60 r/min) for 3 min, and then execute continuously exercise at a constant speed with a power increase of 25 W/min. The load exercise was stopped immediately when the maximum exercise level was reached. Age and body mass index (BMI) were recorded, and cardiopulmonary function indexes such as exercise time, exercise power and respiratory exchange rate (RER) were measured.Results:There was no significant difference on age, BMI and RER among the 4 groups ( P>0.05), but there were significant differences in exercise time and exercise power ( F=6.02, 6.25, P=0.001, P<0.001). Under the condition of the same RER, the exercise time and exercise power of the moderate and high smoking-index group (472.1±54.6 s, 456.9±60.4 s and 197.2±23.1 W, 190.2±24.4 W) were significantly less than those of the non-smoking group (506.3±65.5 s and 211.1±26.9 W) ( P<0.05). Conclusions:This study showed that the exercise time and exercise power of moderate and high smoking-index pilots in increasing power bicycles were significantly lower than those of non-smoking pilots. If the pilots were with moderate-high smoking index their cardiopulmonary function would be affected.