Objective: Diaphragm is the common site of metastasis in advanced ovarian cancer.Diaphragmatic surgery is necessary to achieve complete resection. Relative complications also pose challenges to perioperative management. This study aims to explore the influencing factors and management strategies for perioperative complications of diaphragm surgery. Methods: This study retrospectively included 396 patients who underwent diaphragmatic surgery for advanced ovarian cancer at Fudan University Shanghai Cancer Center from July 2015 to June 2022. Diaphragm surgical methods were classified, and perioperative complications were regarded according to Memorial Sloan Kettering Cancer Center criteria.Clinical characteristics and perioperative complications were analyzed to find correlations to establish the nomogram. Results: Among the 396 patients, 163 patients (41.2%) suffered from perioperative complications. Pleural effusion (33.1%) and pneumothorax (5.3%) were the most commonly reported. Patients with longer surgery duration (>3 hours) (p=0.003) and who underwent diaphragmatic incision surgery (p=0.004) had a higher incidence of postoperative complications. The incidence of postoperative pleural effusion was significantly higher in patients who underwent diaphragm full-thickness resection (49.3%) than diaphragmatic stripping (29.5%) (p=0.001), and patients who underwent diaphragm full-thickness resection are more likely to require drainage (p=0.001). Multi-variate analyses showed that stage IV tumor, long operation time, and diaphragm full-thickness resection are associated with postoperative pleural effusion. Conclusion Pleural effusion is the most common complication of diaphragmatic surgery in patients with ovarian cancer. Routine placement of prophylactic chest tubes is not appropriate for all patients undergoing diaphragmatic surgery. Our nomogram could help to predict its risk and indicate prophylactic management.

The coronavirus disease 2019 (COVID-19) was confirmed by nucleic acid test in 15 juvenile patients aged 4-17 years in Hangzhou Xixi Hospital from January 24 to February 10, 2020. The clinical data and the initial chest high resolution CT (HRCT) findings were retrospectively analyzed.Among 15 cases, 8 patients with a mean age of (6.5±2.3) years (4-11 year) had normal HRCT manifestations (mild disease), while 7 patients with a mean age of (11.9±3.0) years (7-17 years) showed abnormal manifestations (moderate disease). In the 7 moderate cases the CT findings included local thickening of bronchial wall in 2 cases, single lesion in 1 case, bilateral pulmonary lesions in 4 cases. There were total 11 lesions, 6 of which were ground glass and slightly high-density nodules, 5 of which were speckled ground glass and 2 with a little consolidation. There were 10 subpleural lesions, including 7 in the lower lobe of the two lungs, and 1 non-subpleural lesion; the thickened local bronchioles were observed in 3 cases. None of them had hilum and mediastinal lymph node enlargement or pleural effusion.

Objective To evaluate the effects of hanging by the feet OAC-CPR in patients with big hemoptysis suffocation and cardiac arrest.Methods 68 cases of big haemoptysis suffocation and cardiac arrest were randomly divided into two groups.The control group(38 cases) was treated by standard CPR treatment method.The study group (30 cases) was treated by hanging by the feet OAC-CPR method.Results Return of spontaneous circulation (ROSC) of study group was obviously higher than that of control group( 80.0％ vs 55.3％,x2 =4.58,P ＜ 0.05 ).24hours survival of study group was obviously higher than that of control group ( 70.0％ vs 44.7％,x2 =4.34,P ＜0.05).Conclusion Hanging by the feet OAC-CPR can do cardiopulmonary resuscitation and air passage clearing simultaneously in emergency treatment more sufficiently and successfully.

Objective To study the effects of Schwann cell-derived neurotrophic factor(SDNF) on myoblast stem cells(called satellite cells,SCs) in vitro. Methods After setting up SCs culture system in vitro, SCs which treated with various SDNF concentrations culture medium were dynamically evaluated by cell morphology,MTT growth curve and fusion rate. Results The ability of SCs preceding their participation in muscle repair include proliferation and differentiation, 200 ng/ml SDNF stimulated cell proliferation more than the other medium,but 50 ng/ml,100 ng/ml,200 ng/ml,400 ng/ml SDNF made SCs differentiation significantly for their high myotube fusion rate. Conclusion SDNF can regulate the proliferation and differentiation of rat skeletal satellite cellsin vitro,but in differentiation significantly.SDNF might play a role in slowing down denervated muscle atrophy.