Objective:To explore the effects of phased goal directed fluid therapy (GDFT) during anesthesia surgery on tissue perfusion and cognitive function in patients undergoing radical lung cancer surgery.Methods:A total of 108 lung cancer patients were prospectively selected and randomly divided into a control group and a study group using a random number table method. The control group received classical restrictive liquid therapy, while the study group received staged GDFT. We compared the surgical time, intraoperative blood loss, colloid fluid dosage, crystalloid fluid dosage, total output, and urine volume between two groups of patients; Two groups of patients were compared in terms of oxygenation index (OI), respiratory index (RI), central venous oxygen saturation (ScvO 2), lactate (Lac), central venous arterial carbon dioxide partial pressure difference (Pcv-aCO 2), oxygen supply index (DO 2I), and oxygen uptake rate (O 2ERe) before anesthesia induction (T 0), before single lung ventilation (T 1), 1 hour of single lung ventilation (T 2), immediate resumption of dual lung ventilation (T 3), 30 minutes of dual lung ventilation (T 4), and after surgery (T 5); The Mini Mental State Examination (MMSE) was used to evaluate the cognitive function scores of two groups of patients 1 day before surgery and 1 and 3 days after surgery, while recording the incidence of cognitive dysfunction (POCD) and pulmonary complications (including pulmonary infection, acute lung injury, pulmonary embolism, pulmonary edema, atelectasis, etc.) within 3 days after surgery. Results:The amount of crystal fluid and urine output in the research group was significantly lower than that in the control group, while the amount of colloidal fluid was significantly higher than that in the control group (all P<0.05). The OI of the study group T 1-T 5 was significantly higher than that of the control group, while the RI of T 2-T 5 was significantly lower than that of the control group (all P<0.05). The ScvO 2 of the study group T 1 to T 5 was significantly higher than that of the control group, and the Lac was significantly lower than that of the control group (all P<0.05); The MMSE scores of both groups of patients were significantly lower than those before surgery on day 1 and 3 after surgery, and the MMSE scores of the study group were significantly higher than those of the control group on day 1 and 3 after surgery (all P<0.05). The incidence of POCD within 3 days after surgery in the study group was 16.67%(9/54), lower than 37.04%(20/54) in the control group (χ 2=5.704, P=0.017); The incidence of pulmonary complications in the study group was lower than that in the control group (5.56% vs 22.22%, χ 2=4.955, P=0.026). Conclusions:The application of staged GDFT during anesthesia in patients undergoing radical lung cancer surgery can further improve tissue perfusion, improve microcirculation and oxygen supply-demand balance of systemic organs and tissues, including the brain, alleviate perioperative brain function damage, and reduce the occurrence of postoperative POCD compared to conventional liquid therapy.

Objective:To explore risk factors associated with the live birth in patients with long-acting follicular phase in fresh single embryo transfer cycle and to construct nomogram prediction model for providing a reference for clinical decision-making and individualized treatment.Methods:An assisted reproduction population-based retrospective cohort analysis of the clinical data of 2 795 patients with long-acting follicular phase in fresh single embryo transfer cycle who underwent in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) was performed in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to December 2020. These patients were randomly divided into modeling group and validation group according to 3∶1. Univariate and multivariate logistic regression were used to screen potential risk factors for newborn live birth after fresh single embryo transfer. The nomogram model was established according to the regression coefficients. Besides, area under the receiver operator characteristic (ROC) curve, calibration curve and decision curve analysis were used to evaluate the discrimination and calibration of the model. Results:Through multiple logistic regression analysis, female age, progestational polycystic ovary syndrome (PCOS), the level of progestrogen on the day of human chorionic gonadotropin (hCG) injection, high-quality embryo rate, type of embryos transferred were independent risk factors associated with live birth. Stratified analysis found age ≥36 years together with the level of progestrogen ≥5.20 nmol/L on the day of hCG injection could reduce the probability of live birth signally, and statistically significant interaction was found ( P=0.043). The level of progestrogen ≥5.20 nmol/L on the day of hCG injection together with high-quality embryo rate <59.60% could reduce the probability of live birth signally, and statistically significant interaction was found ( P=0.010). The area under the curve (AUC) of modeling group and validation group was 0.637 (95% CI: 0.615-0.658) and 0.617 (95% CI: 0.579-0.654), respectively. The calibration curve showed that the predicted value of the model was in good agreement with the actual value. The decision curve analysis indicated the most benefical clinical effect with the nomogram for live birth under threshold probabilities of 24.05%-68.75%, it had a good diagnostic value for clinical decision. Conclusion:Female age, progestational PCOS, the level of progestrogen on the day of hCG injection, high-quality embryo rate, type of embryos transferred were independent risk factors associated with live birth in patients with long-acting follicular phase in fresh single embryo transfer cycle. Female age ≥36 years and high-quality embryo rate <59.60% together with the level of progestrogen ≥5.26 nmol/L on the day of hCG injection respectively could reduce the probability of live birth. The nomogram predictive model based on the above factors contribute to predict the probability of live birth.

Objective:To explore risk factors associated with the live birth in patients with long-acting follicular phase in fresh single embryo transfer cycle and to construct nomogram prediction model for providing a reference for clinical decision-making and individualized treatment.Methods:An assisted reproduction population-based retrospective cohort analysis of the clinical data of 2 795 patients with long-acting follicular phase in fresh single embryo transfer cycle who underwent in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) was performed in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to December 2020. These patients were randomly divided into modeling group and validation group according to 3∶1. Univariate and multivariate logistic regression were used to screen potential risk factors for newborn live birth after fresh single embryo transfer. The nomogram model was established according to the regression coefficients. Besides, area under the receiver operator characteristic (ROC) curve, calibration curve and decision curve analysis were used to evaluate the discrimination and calibration of the model. Results:Through multiple logistic regression analysis, female age, progestational polycystic ovary syndrome (PCOS), the level of progestrogen on the day of human chorionic gonadotropin (hCG) injection, high-quality embryo rate, type of embryos transferred were independent risk factors associated with live birth. Stratified analysis found age ≥36 years together with the level of progestrogen ≥5.20 nmol/L on the day of hCG injection could reduce the probability of live birth signally, and statistically significant interaction was found ( P=0.043). The level of progestrogen ≥5.20 nmol/L on the day of hCG injection together with high-quality embryo rate <59.60% could reduce the probability of live birth signally, and statistically significant interaction was found ( P=0.010). The area under the curve (AUC) of modeling group and validation group was 0.637 (95% CI: 0.615-0.658) and 0.617 (95% CI: 0.579-0.654), respectively. The calibration curve showed that the predicted value of the model was in good agreement with the actual value. The decision curve analysis indicated the most benefical clinical effect with the nomogram for live birth under threshold probabilities of 24.05%-68.75%, it had a good diagnostic value for clinical decision. Conclusion:Female age, progestational PCOS, the level of progestrogen on the day of hCG injection, high-quality embryo rate, type of embryos transferred were independent risk factors associated with live birth in patients with long-acting follicular phase in fresh single embryo transfer cycle. Female age ≥36 years and high-quality embryo rate <59.60% together with the level of progestrogen ≥5.26 nmol/L on the day of hCG injection respectively could reduce the probability of live birth. The nomogram predictive model based on the above factors contribute to predict the probability of live birth.

Transuranics radionuclides are ubiquitous in the environment. Long term intake will cause internal radiation hazards, and it is also an important source of radioactive contamination to the environment in the future. In this paper, the source and migration behavior of transuranic radionuclides are reviewed, the existing problems in China are summarized, and the suggestions for future work are put forward.

Chronic myeloid leukemia (CML) is a slowly progressing hematopoietic cell disorder. Sphingosine kinase 1 (SPHK1) plays established roles in tumor initiation, progression, and chemotherapy resistance in a wide range of cancers, including leukemia.However, small-molecule inhibitors targeting SPHK1 in CML still need to be developed. This study revealed the role of SPHK1 in CML and investigated the potential anti-leukemic activity of hirsuteine (HST), an indole alkaloid obtained from the oriental plant Uncaria rhynchophylla, in CML cells. These results suggest that SPHK1 is highly expressed in CML cells and that overexpression of SPHK1 represents poor clinical outcomes in CML patients. HST exposure led to G2/M phase arrest, cellular apoptosis, and downregulation of Cyclin B1 and CDC2 and cleavage of Caspase 3 and PARP in CML cells. HST shifted sphingolipid rheostat from sphingosine 1-phosphate (S1P) towards the ceramide coupled with a marked inhibition of SPHK1. Mechanistically, HST significantly blocked SPHK1/S1P/S1PR1 and BCR-ABL/PI3K/Akt pathways. In addition, HST can be docked with residues of SPHK1 and shifts the SPHK1 melting curve, indicating the potential protein-ligand interactions between SPHK1 and HST in both CML cells. SPHK1 overexpression impaired apoptosis and proliferation of CML cells induced by HST alone. These results suggest that HST, which may serve as a novel and specific SPHK1 inhibitor, exerts anti-leukemic activity by inhibiting the SPHK1/S1P/ S1PR1 and BCR-ABL/PI3K/Akt pathways in CML cells, thus conferring HST as a promising anti-leukemic drug for CML therapy in the future.

Objective:To explore the correlation between abdominal aortic calcification and serum cell division cycle 42 (CDC-42) in maintenance hemodialysis (MHD) patients, and to explore the influencing factors of them.Methods:A cross-sectional study was conducted in the Blood Purification Center of Qingdao Municipal Hospital,112 patients who underwent MHD for more than 6 months from October 2019 to March 2021 were selected. The abdominal aortic calcification score (ACCs) was calculated by reference to the abdominal lateral X flat tablets. According to AACS, 50 cases were divided into no and mild calcification group (0≤AACS<5 points) and 62 cases were divided into moderate and severe calcification group (AACS≥5 points). The level of serum CDC-42 was detected by enzyme linked immunosorbent assay (ELISA). Taking the median serum CDC-42 level as the boundary, 56 cases were divided into low CDC-42 group and high CDC-42 group. Spearman correlation analysis was used to analyze the correlation between indicators. The risk factors of elevated CDC-42 and abdominal aortic calcification in MHD patients were explored by multivariate logistic regression analysis, and the variables were included by entry method.Results:In 112 patients, 91 cases (81.25%, 91/112) had abdominal aortic calcification, and the median serum CDC-42 level was 466.56 (335.56,623.57) ng/L. CDC-42, AACs, age, dialysis age, diabetic nephropathy, glycosylated hemoglobin, alkaline phosphatase, parathormone and calcium in the no and mild calcification groups were 347.77 (291.20, 419.53) ng/L, 1.00 (0.00, 3.00) points, (57.18±6.25) years, 31.50 (15.00, 49.25) months, 34.00%(17/50), (6.63±0.97)%, 116.22 (87.32, 152.13) U/L, 258.57 (143.40, 433.31) ng/L, (2.18±0.26) mmol/L, and in the moderate to severe calcification group were 602.69 (489.61, 762.73) ng/L, 10.00 (7.00, 16.25) points, (60.81±7.12) years, 49.00 (18.00, 67.00) months, 53.23%(33/62), (7.07±1.20)%, 144.34 (99.71, 201.76) U/L, 336.57 (230.63, 506.00) ng/L,(2.28±0.26) mmol/L, with statistically significant differences between the two groups(The statistical values were 6.99, 9.11, 2.83, 2.45, 4.14, 2.08, 2.04, 2.16 and 1.99, respectively, all P<0.05). CDC-42, AACs, glycosylated hemoglobin and parathormone in the low CDC-42 group were 336.50 (295.10, 395.25) ng/L, 2.00 (0.00, 4.00) points, (6.62±1.06) %, 250.60 (140.20, 462.02) ng/L,and in the high CDC-42 group were 622.92 (558.11, 836.65) ng/L, 10.00 (6.25, 15.75) points, (7.13±1.13) %, 347.21 (240.40,501.20) ng/L, with statistically significant differences between the two groups (The statistical values are 6.51, 5.21, 2.43 and 2.54, respectively,all P<0.05). Abdominal aortic calcification has positive correlations with CDC-42 ( r s=0.704, P<0.001), age ( r s=0.308, P=0.001), dialysis years ( r s=0.198, P=0.036), glycosylated hemoglobin ( r s=0.358, P<0.001), alkaline phosphatase ( r s=0.187, P=0.048), parathormone ( r s=0.437, P<0.001), serum calciu m( r s=0.323, P=0.001) and serum phospho-rus ( r s=0.251, P=0.007), and negative correlation with serum albumin( r s=-0.276, P=0.003). This study has confirmed that high serum CDC-42 ( OR=1.010, 95%CI:1.004-1.016, P=0.001) and senior dialysis age ( OR=1.033, 95%CI:1.006-1.061, P=0.018) were independent risk factors for moderate to severe abdominal aortic calcification.Serum CDC-42 levels has positive correlation with AACs ( r s=0.704, P<0.001), age ( r s=0.240, P=0.011), dialysis age ( r s=0.191, P=0.044), glycosylated hemoglobin ( r s=0.350, P<0.001), parathormone ( r s=0.380, P<0.001) and serum calcium ( r s=0.235, P=0.013). This study learned that,high AACs ( OR=1.185, 95%CI:1.037-1.354, P=0.013) and high parathormone ( OR=1.005, 95%CI:1.001-1.009, P=0.009) were independent risk factors for high CDC-42. The area under the receiver operating characteristic curve (ROC-AUC) of serum CDC-42 in predicting moderate and severe abdominal aortic calcification in MHD patients was 0.885. When the cut-off point was 466.56 ng/L, the predictive sensitivity and specificity were 79% and 86% respectively. Conclusion:The degree of abdominal aortic calcification in MHD patients was positively correlated with the level of serum CDC-42. High serum CDC-42 and high dialysis age were independent risk factors for abdominal aortic calcification in MHD patients. High AACS and high parathyroid hormone were independent risk factors for the increase of serum CDC-42 in MHD patients .

Objective:To overcome the disadvantages of bismuth removal by bismuth sulfide precipitation method recommended by existing analytical standards and improve the quality of analytical result.Methods:Based on 201×7 anion exchange resin, the experimental process of bismuth removal was designed, and verified by using spiked samples and IAEA test samples.Results:Bismuth was removed by anion exchange resin. In the removal experiments of strontium, yttrium and bismuth, the chemical recovery rate of strontium and yttrium could reach (98.6 ± 0.8)% and (98.5 ± 0.7)%, respectively, with no Bi 2S 3 precipitation found. The relative standard deviation between analytical result and theoretical values was -2.97% to 5.94%, better than 3.96%-17.8% by the standard bismuth removal method. Through validation using IAEA test samples, the relative standard deviation between the reported value and the target value for 90Sr was between 3.40%-7.09%, and all the results were acceptable. Conclusions:Bismuth could be quantitatively removed using anion exchange resin without adsorption of strontium and yttrium. In addition, the bismuth removal solution system of anion exchange resin was the same as the elution system in 90Sr analysis, and the purpose of rapid bismuth removal could be achieved without conversion system. Compared with the current standard analytical method, it was feasible and better to quantitatively remove bismuth based on anion exchange resin, which could meet the needs of routine analysis of 90Sr.

【Objective】 To explore and evaluate infection control measures of preventing cross-contamination of novel coronavirus during gastrointestinal endoscopy treatment. 【Methods】 According to the hospital’s infection control requirements and related documents, infection control measures were formulated and implemented by combining with our actual clinical situation, including the management of the endoscope room, management and protection of patients and endoscopists. Then, we evaluated the effect of these measures. 【Results】 From January 25 to March 10, 2020, a total of 71 patients (53 males and 18 females) completed gastrointestinal endoscopy treatment, with an average age of 54 years (28-81 years). There were 36 (50.7%) cases of emergency treatment. All patients had been kept in quarantine for about 14 days (24±13), and no cross-contamination of novel coronavirus occurred. 【Conclusion】 During the novel coronavirus infection epidemic period, reasonable and effective measures should be taken to minimize the risk of infection in doctors and patients. The endoscope center should strengthen preoperative screening and management of patients, master indications of endoscopic procedures, complete endoscopists’ management and protection work, strictly follow the specifications of sterilizing gastrointestinal endoscopes, and construct the layout of "three zones and two passages".

Objective:To investigate the effects of three different luteal phase support protocols on pregnancy outcomes in hormone replacement therapy frozen-thawed embryo transfer(HRT-FET).Methods:The clinical data of 3288 HRT-FET cycles in Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2016 to February 2019 were retrospective cohort study analyzed. The cycles were divided into three groups according to luteal phase support protocols. The patients received a combination of progesterone soft capsule and dydrogesterone in group A (478 cycles), the patients received a combination of progesterone vaginal sustained-release gel and dydrogesterone in group B (1293 cycles), the patients received a combination of progesterone injection and dydrogesterone in group C (887 cycles). Pregnancy outcomes and neonatal outcomes in group A, group B and group C were compared.Results:The clinical pregnancy rate, the 12-week pregnancy rate and the live birth rate had no significant difference among the three groups ( P>0.05). The rates of premature delivery and twin delivery [19.90% (78/392), 30.61% (120/392)] in group C were higher than those in group B [13.61% (109/801), P=0.011; 20.47% (164/801), P<0.001]. The birth weight [(3 178.60±635.38) g] in group B was significantly higher than that in group C [(3 033.01±682.54) g, P<0.001] . There was no significant difference in the incidence of birth defects among the three groups ( P>0.05). Logistic regression analysis showed that three different luteal phase support regimens were not associated with 12-week pregnancy rate. Conclusion:In HRT-FET cycle, progesterone soft capsule or progesterone vaginal sustained-release gel combined with dydrogesterone can achieve the same pregnancy outcome as progesterone injection combined with dydrogesterone, but a large-scale prospective study is needed.

Objective:To investigate the effects of three different luteal phase support protocols on pregnancy outcomes in hormone replacement therapy frozen-thawed embryo transfer(HRT-FET).Methods:The clinical data of 3288 HRT-FET cycles in Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2016 to February 2019 were retrospective cohort study analyzed. The cycles were divided into three groups according to luteal phase support protocols. The patients received a combination of progesterone soft capsule and dydrogesterone in group A (478 cycles), the patients received a combination of progesterone vaginal sustained-release gel and dydrogesterone in group B (1293 cycles), the patients received a combination of progesterone injection and dydrogesterone in group C (887 cycles). Pregnancy outcomes and neonatal outcomes in group A, group B and group C were compared.Results:The clinical pregnancy rate, the 12-week pregnancy rate and the live birth rate had no significant difference among the three groups ( P>0.05). The rates of premature delivery and twin delivery [19.90% (78/392), 30.61% (120/392)] in group C were higher than those in group B [13.61% (109/801), P=0.011; 20.47% (164/801), P<0.001]. The birth weight [(3 178.60±635.38) g] in group B was significantly higher than that in group C [(3 033.01±682.54) g, P<0.001] . There was no significant difference in the incidence of birth defects among the three groups ( P>0.05). Logistic regression analysis showed that three different luteal phase support regimens were not associated with 12-week pregnancy rate. Conclusion:In HRT-FET cycle, progesterone soft capsule or progesterone vaginal sustained-release gel combined with dydrogesterone can achieve the same pregnancy outcome as progesterone injection combined with dydrogesterone, but a large-scale prospective study is needed.