Objective:To analyze the changes and significance in clinical cardiac indicators of early cardiac myocardial dysfunction and cardiac substructure dose during conventional radiotherapy for N 2-N 3 non-small cell lung cancer (NSCLC) with mediastinal lymph node metastases. Methods:The data of 34 NSCLC patients with lymph node metastases in regions 4-8 admitted to the Affiliated Cancer Hospital of Guizhou Medical University from June 2022 to August 2023 were observed and analyzed. All patients were treated with volumetric modulated arc therapy with a prescribed dose of 60-70 Gy. Cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured at 6 time points: within 1 week before radiotherapy ( t0); when the cumulative radiotherapy dose reaches 20 Gy ( t20), 40 Gy ( t40), 60 Gy ( t60) during radiotherapy; within 1 week after radiotherapy ( tp); 1 month after radiotherapy( tp1). Left ventricular global longitudinal strain (LVGLS) and left atrial global longitudinal strain (LAGLS) were assessed at 4 time points: t0, t40, tp and tp1, respectively. The changes in cardiac indicators at different time points during radiotherapy and their correlation with substructure doses were analyzed using analysis of variance, linear regression analysis, and Pearson correlation. Results:The correlation between cardiac substructure dose and mean heart dose (MHD) in the study cohort in the descending order was as follows: left ventricle ( B=0.43, P<0.001), right ventricle ( B=0.37, P=0.002), left atrium ( B=0.16, P<0.001), and right atrium ( B=0.15, P=0.001). There were significant differences in the changes of LVGLS and LAGLS across different time points ( F=3.13, P=0.029; F=17.18, P<0.001). At 1 month after radiation, LAGLS was significantly decreased compared to pre-radiation levels ( P=0.009), whereas no significant difference was observed in LVGLS ( P=1.000). No significant differences were observed in the changes of cTnT and NT-proBNP across different time points (all P>0.05). Significant correlations were identified between cTnT and right ventricle mean dose at t40 ( r=0.38, P=0.025), as well as between NT-proBNP and right atrium mean dose at t60 and tp ( r=0.54, P=0.001; r=0.41, P=0.016). Conclusions:At present, there is no significant difference between the sensitive serum markers of myocardial injury and LVGLS in detecting early myocardial injury. LAGLS may hold substantial clinical value. There is uncertainty about radiation injury and repair of various cardiac substructures.

Objective:To analyze the changes and significance in clinical cardiac indicators of early cardiac myocardial dysfunction and cardiac substructure dose during conventional radiotherapy for N 2-N 3 non-small cell lung cancer (NSCLC) with mediastinal lymph node metastases. Methods:The data of 34 NSCLC patients with lymph node metastases in regions 4-8 admitted to the Affiliated Cancer Hospital of Guizhou Medical University from June 2022 to August 2023 were observed and analyzed. All patients were treated with volumetric modulated arc therapy with a prescribed dose of 60-70 Gy. Cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured at 6 time points: within 1 week before radiotherapy ( t0); when the cumulative radiotherapy dose reaches 20 Gy ( t20), 40 Gy ( t40), 60 Gy ( t60) during radiotherapy; within 1 week after radiotherapy ( tp); 1 month after radiotherapy( tp1). Left ventricular global longitudinal strain (LVGLS) and left atrial global longitudinal strain (LAGLS) were assessed at 4 time points: t0, t40, tp and tp1, respectively. The changes in cardiac indicators at different time points during radiotherapy and their correlation with substructure doses were analyzed using analysis of variance, linear regression analysis, and Pearson correlation. Results:The correlation between cardiac substructure dose and mean heart dose (MHD) in the study cohort in the descending order was as follows: left ventricle ( B=0.43, P<0.001), right ventricle ( B=0.37, P=0.002), left atrium ( B=0.16, P<0.001), and right atrium ( B=0.15, P=0.001). There were significant differences in the changes of LVGLS and LAGLS across different time points ( F=3.13, P=0.029; F=17.18, P<0.001). At 1 month after radiation, LAGLS was significantly decreased compared to pre-radiation levels ( P=0.009), whereas no significant difference was observed in LVGLS ( P=1.000). No significant differences were observed in the changes of cTnT and NT-proBNP across different time points (all P>0.05). Significant correlations were identified between cTnT and right ventricle mean dose at t40 ( r=0.38, P=0.025), as well as between NT-proBNP and right atrium mean dose at t60 and tp ( r=0.54, P=0.001; r=0.41, P=0.016). Conclusions:At present, there is no significant difference between the sensitive serum markers of myocardial injury and LVGLS in detecting early myocardial injury. LAGLS may hold substantial clinical value. There is uncertainty about radiation injury and repair of various cardiac substructures.

Disorders of the gut flora (GF) affect the level of 5-hydroxytryptamine (5-HT) in the brain of patients with generalized anxiety disorder (GAD) and influence the development of the disease. Most of the acupuncture points selected for GAD are based on the principles of local acupuncture points and acupuncture points following the distant channels of the meridians, regarding Baihui (DU 20), Fengchi (GB 20), and Yintang (GV 29) as the main acupuncture points, and the acupuncture points selected for the regulation of GF are Zhongwan (CV 12), Tianshu (ST 25), and Guanyuan (RN 4) and Zusanli (ST 36). Recently, many studies have been conducted on the mechanism of action of acupuncture in the treatment of GAD from the perspective of GF, but few have investigated the theoretical of acupuncture points used to prevent and treat GAD. This paper discusses the theoretical basis of acupuncture to regulate the "microbiota-gut-brain axis" (MGBA) for the prevention and treatment of GAD, and proposes the method of "regulating the internal organs and calming the mind and relieving anxiety" through analyzing the researches on the regulation of GF and GAD.

Objective: To explore a predictive model for outcomes of severe acute pancreatitis (SAP) patients. Methods: A retrospective study was conducted of 102 SAP patients from January 1,2016 to April 30,2018 from Taizhou Hospital in this study. The participants were divided into survival group and death group according to the outcome of 90 days after admission,88 cases were in survival group including 57 males and 31 females, aged 55.5 (40.3-69.8) years; 14 cases were in death group including 5 males and 9 females, aged 63.0 (50.8-80.8) years. Clinical data and laboratory indicators were compared between the two groups. Statistical analyses were performed to compare categorical variables. Chi-square automatic interaction detector (CHAID) was used to construct the prediction model of SAP patients′ outcomes. The study cohort consisted of SAP patients from August 1st 2018 to July 1st 2019 were collected to validate the prediction model. Results: (1)Statistical analyses were performed by chi square test and Mann-Whitney U test. There were statistically significant differences in the proportion of cardiovascular and cerebrovascular diseases, mechanical ventilation and septic shock, and also the Charlson complication index (CCI), the Ranson score and APACHEⅡscore(χ²=5.554, P=0.018; χ²=5.585,P=0.018;P=0.008;Z=-3.007,P=0.003;Z=-2.982, P=0.003; Z=-3.257, P=0.001), death group were higher than survival group. (2) The MPV, CRP, MCHC, pH, pCO2 and positive rates of NRBC were statistically different between survival group and death group(Z=-2.466,P=0.014;Z=-2.689,P=0.007;Z=-2.238,P=0.025;Z=-1.977,P=0.048;Z=-2.239, P=0.025;P=0.000).The NRBC-positive rate in the death group was higher than that in the survival group, while the other indexes were lower in the survival group.(3)The decision tree CHAID method obtains the prediction scheme: when it meets the Ranson score≤3, the SAP patients were judged to be alive; when it meets the Ranson score>3 and the NRBC in peripheral blood was negative, the SAP patients were judged to be alive; when it meets the Ranson score>3, the NRBC was positive and the APACHEⅡscore≤21, the SAP patients were judged to be alive; when it meets the Ranson score>3, NRBC was positive and APACHE Ⅱ>21, the SAP patients were adverse prognosis. (4) 50 SAP patients were collected in the validation group, with 43 actual survivors and 7 deaths. The accuracy rate of predicting the outcomes of SAP patients in validation group with the scheme was 94.0% (47/50). Conclusion The NRBC combined with Ranson score system and APACHE II score system can predict the outcomes of SAP patients.

Objective:To observe the effect of thoracic infusion of pseudomonas aeruginosa injection in malignant pleural effusion. Methods:A total of 90 patients with malignant pleural effusion were randomly divided into treatment group (31 cases),control group A (29 cases) and control group B(30 cases). Treatment group was treated with pseudomonas aeruginosa through intrathoracic infusion. Control group A and B were respectively treated with cisplatin and interleukin-2 through intrathoracic infusion. The clinical efficacy and adverse reaction were compared among the three groups. Results:The total effective rate of treatment group was 80.6%,the total effective rates of the control group A and B were 51.7%and 56.7%respectively.Compared with that of contral groups, the total effective rate of treatment group was higher, and the differences were statistically significant (P<0.05). The incidence of serious side effects and toxicity was lower in treatment group than in control groups. Conclusion:The effect of thoracic infusion of pseudomonas aeruginosa injection for malignant pleural effusion is significant, and the adverse reaction is mild. Thus it is worth to be promoted clinically.

Objective To evaluate the diagnostic value of Human Epididymal Protein 4(HE4) and HE4/Cancer Antigen 125 (CA125) parallel detection for ovarian cancer by meta-analysis.Methods The databases,such as Pubmed,Embase and China National Knowledge Infrastructure (CNKI),were employed to search for the studies related to diagnostic value of HE4 and HE4/CA125 parallel detection for ovarian cancer.The screening,data extraction and quality assessment were conducted in accordance with the inclusion and exclusion criteria by two reviewers independently.The software Meta-disc 1.4 was used to perform meta-analysis and draw the forest plots and the Summary Receiver Operating Characteristic (SROC) curves.The AUCs of HE4,HE4/CA125 parallel detection were detected by Z test.The Egger's regression test was applied to evaluate the publication bias by Stata11.0.Results A total of 14 studies with benign control and/or healthy control were included.In the studies with healthy control.The AUCs of HE4,HE4/CA125 parallel detection were 0.9502 ± 0.0137 and 0.9588 ± 0.0113 respectively,but there was no significant difference between them (Z =0.484,P ＞ 0.05) ;In the studies with benign control.The value of cutoff was the most important cause of heterogeneity.The AUCs of HE4,HE4/CA125 parallel detection were 0.9153 ± 0.0095 and 0.9323 ± 0.0082 respectively,but with no significant difference (Z =1.350,P ＞ 0.05).In the subgroup with cut-off value divided by 150 pmoL/L,the AUCs of HE4,HE4/CA125 parallel detection were 0.9032±0.0174 and 0.9267 ±0.0176 respectively,but there was no significant difference between them (Z =0.950,P ＞ 0.05).Conclusions Both HE4 and HE4/CA125 parallel detection had meaningful values for the diagnosis of ovarian cancer.The detection of HE4 had a higher specificity,while the HE4/CA125 parallel detection had a higher sensitivity.But there was no statistical difference between them in diagnosis value of ovarian cancer.