Objective To explore the symptom prevalence in the patients with pulmonary nodules in Lingnan area and to investigate the influencing factors,thus to provide data support for the construction of differentiation and treatment system of symptoms-syndrome elements-syndromes-constitutions for patients with pulmonary nodules,and to promote the establishment of secondary prevention system of lung cancer with the in-depth participation of traditional Chinese medicine(TCM).Methods A cross-sectional study was adopted to investigate patients with pulmonary nodules who admitted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from August 2023 to January 2024.Data collection covered the basic information,clinical characteristics and symptoms of the patients.Likert four-level scale was used for the grading of the severity of the symptoms,multivariate linear regression was adopted to construct three regression models,and then the factors influencing the severity of symptoms of patients with pulmonary nodules were explored.Results(1)A total of 274 patients were enrolled in the analysis,including 160 females and 114 males,with a mean age of(54.44±12.00)years old and the symptom scores averaging(3.97±3.80)point.The included patients with pulmonary nodules were characterized by females outnumbering males,a higher proportion of middle-aged and elderly people,multiple pulmonary nodules being more common.(2)The analysis of the symptoms of the 274 patients showed that symptoms with an incidence over 30%were fatigue(116 cases,42.34%),cough(105 cases,38.32%),expectoration of white sputum(89 cases,32.48%),and irritability and distress(87 cases,31.75%).(3)Multivariate linear regression analysis after variable adjustment suggested that the overall symptomatic severity in the male was milder than that in the female[β=-1.67,95%CI(-2.67,-0.68),P<0.001],and symptom score was positively correlated with age[β=0.07,95%CI(0.03,0.10),P<0.001],history of exposure to secondhand smoke[β=1.27,95%CI(0.26,2.27),P=0.015],history of exposure to other hazardous substances[β=1.96,95%CI(0.39,3.53),P=0.015],and history of allergy[β=2.38,95%CI(1.22,3.54),P<0.001]significantly.Conclusion The overall symptoms of patients with pulmonary nodules in Lingnan area are mild,and the high prevalence of symptoms are fatigue,cough,expectoration of white sputum,and irritability and distress.The symptom severity is correlated with gender,age,history of exposure to secondhand smoke,history of exposure to other hazardous substances,and history of allergy.

Objective To investigate the effect of intraoperative renal artery resistance index(RI)in predicting postoperative acute kidney injury(AKI)in patients undergoing cardiac surgery with cardiopul-monary bypass(CPB).Methods Forty-four patients undergoing elective cardiac surgery with CPB,21 males and 23 females,aged ≥18 years,BMI 18.5-30.0 kg/m2,ASA physical status Ⅰ-Ⅲ,were select-ed.Left renal artery peak systolic velocity(PSV)and end-diastolic velocity(EDV)were measured by transesophageal echocardiography(TEE)20 minutes after general anesthesia induction(T1)and 30 minutes after CPB cessation(T2).RI was calculated as(PSV-EDV)/PSV.Patients were divided into two groups:the AKI group and the non-AKI group,according to whether occurred AKI by the diagnostic criteria of the kidney disease:improving global outcomes organization(KDIGO).Logistic multivariate regression analysis was performed to identify the risk factors for AKI occurrence.Results Sixteen patients(36％)oc-curred AKI.Compared with the non-AKI group,the CPB duration and aortic cross-clamp duration were sig-nificantly prolonged(P＜0.05),the renal artery RI at T,and T2 were significantly increased in the AKI group(P＜0.05).Multivariate logstic analysis showed that RI at T2 was an independent risk factor for AKI occurrence after cardiac surgery,the AUC was 0.893(95％CI 0.794-0.991,P＜0.010),the sensitivity and specificity were 84.5％and 78.6％,respectively,and the cut-off value was 0.720.Conclusion Intra-operative renal artery RI in patients undergoing cardiac surgery is an independent risk factor for AKI after cardiac surgery,and renal artery RI＞0.720 at 30 minutes after CPB cessation can serve as a predictive in-dicator for AKI after cardiac surgery.

Objective To investigate the effects of different deflation methods of endotracheal tube cuff on coughing response and hemodynamics during extubation. Methods Ninety patients undergoing elective surgery for endotracheal intubation under general anesthesia were selected as study subjects and randomly divided into study group and control group, with 45 patients in each group. In the study group, the cuff end of the endotracheal tube cuff was connected to a syringe and a non-liquid pressure gauge through a three-way stopcock. Before extubation, the cuff was aspirated to decrease the cuff pressure at a rate of 3 cmH₂O/s. In the control group, the gas in cuff was rapidly deflated by aspirating all the gas inside with a syringe during extubation. The incidence and severity of coughing response during extubation were recorded in both groups. Mean arterial pressure (MAP) and heart rate (HR) were recorded before induction of general anesthesia (T₀), before cuff deflation (T₁), immediately after cuff deflation (T₂), 1 minute after extubation (T₃), 3 minutes after extubation (T₄), and 5 minutes after extubation (T₅). Adverse events were also recorded in both groups. Results The coughing response during extubation started immediately after cuff deflation in both groups. The incidence and severity of coughing response were lower in the study group than in the control group (P < 0.05). Compared with the control group, values of MAP were lower at T₂ to T₄ and values of HR were lower at T₂ to T₅ in the study group (P < 0.05). The incidence of post-extubation pharyngeal discomfort was 6.67 % in the study group, which was lower than 26.67 % in the control group (P < 0.05). There was no significant difference in the incidence of post-extubation hypoventilation between the two groups (P>0.05). Conclusion The method of slowly reducing the pressure of the endotracheal tube cuff at a constant rate can reduce the incidence and severity of coughing, decrease postoperative extubation complications, and stabilize hemodynamics, with better effects than the method of rapidly aspirating all the gas inside the cuff at once.

Humans ; COVID-19/genetics* ; SARS-CoV-2/genetics* ; Clustered Regularly Interspaced Short Palindromic Repeats/genetics* ; CRISPR-Cas Systems/genetics* ; RNA, Viral/genetics*

Mushroom-derived cyathane-type diterpenes possess unusual chemical skeleton and diverse bioactivities. To efficiently supply bioactive cyathanes for deep studies and explore their structural diversity,

Objective To investigate the influence of Tai Chi posture on knee joint load and the strategy of coordinated muscle contraction. Methods Twenty Tai Chi practitioners with more than 3 years of Tai Chi practice was recruited. By using high-speed motion capture system andthree-dimensional force plate, the adduction angle, tibial angle, joint force, joint torque of the supporting leg during the Tai Chi step lunge movement were collected, and the quadriceps and gastrocnemius muscle strength were obtained through simulation method. The muscle strength performance, recruitment mode and activation method of baseline step, toe-out step and toe-in step were compared. ResultsThe tibial angle and adduction force increased in the toe-out step but those parameters in the toe-in step remained unchanged; the strength of the medial femoris, semimembranosus, semitendinosus and lateral gastrocnemius muscle increased in the toe-out step; the external femoral muscle and medial gastrocnemius muscle increased in the toe-in step. The gastrocnemius muscle was preferentially activated than the quadriceps muscle, and the way of muscle recruitment changed. Conclusions Tai Chi posture will change the way of muscle force recruitment and affect the knee joint function. Standardized movements can be used as the reference for osteoarthritis exercise therapy and have some significance in clinical application.

Given that the current Newcastle disease virus (NDV) infection in wild birds poses the threat to poultry, surveillance of Newcastle disease in captive wild birds was carried out in Jilin, China in 2018. Here, an NDV strain obtained from toco toucan was firstly characterized.The results showed that the F gene of the NDV isolate Toucan/China/3/2018 is classified as genotype II in class II. Sequence analysis of the F0 cleavage site was 113 RQGR/L 117 , which supports the result of the intracerebral pathogenicity index assay indicating classification of the isolate as low-pathogenicity. Experimental infection demonstrated that Toucan/ China/3/2018 can effectively replicate and transmit among chickens. To our knowledge, this is the first report on genetically and pathogenically characterizing NDV strain isolated from toucan, which enriches the epidemiological information of NDV in wild birds.

Objective To predict the presence of MVI,the general clinicopathological of HCC patients' data of the preoperative neutrophil-lymphocyte ratio (NLR),platelet-lymphocyte ratio (PLR),altplatelet ratio (APRI) were evaluated.Methods 143 cases of HCC patients who underwent radical resection and ≤ 5 cm of tumor diameter in Chifeng Clinical Medical School of Inner Mongolia Medical University from January 2011 to December 2014 were analysed retrospectively and followed up.The relationship between NLR,PLR,APRI and other clinical parameters was evaluated.Results According to ROC Curve,the NLR truncation value was 2.00,PLR to 115.00,APRI 1.6.The single factor analysis of x2 test showed that NLR (x2=6.419;P＜0.05),APRI (x2=3.975;P＜0.05),AFP (x2=33.37;P＜0.05),Degree of differentiation (x2 =9.839;P＜0.05) were significant differences between MVI positive (MVI+) and negative (MVI-) groups,and the difference was statistically significant;Logistic regression multifactor analysis showed that NLR (OR 2.678;95％ CI 1.033～6.944;P＜0.05) and AFP (OR 1.724;95％CI 1.023～2.905;P＜0.05) are independent predictors of MVI.Conclusion Preoperative NLR and AFP are convenient,economical and reliable hematological indices for predicting the presence of MVI in HCC patients.

Objective: To investigate the regulation of AMPK-mTOR signal transduction pathway in paraquat-induced autophagy of pheochromocytoma cells (PC12) . Methods: The PC12 cell were treated with terminal concentrations of 0, 25, 50, 100, 200, 300 and 400 μmol/L PQ for 24 hours, and the cells were induced by 300 μmol/L PQ for different time (6, 12, 24, 48 h) . MTT was used to detect the relative survival rate of cells, and the dose/time-effect relationship was determined respectively. The cells were treated with PQ at concentrations of 0, 100, 200 and 300 μmol/L PQ for 24 hours, the lactate dehydrogenase (LDH) activity in the culture supernatant was detected by spectrophotometry. The expression and distribution of autophagic lysosomes were observed by MDC staining. The intracellular reactive oxygen species (ROS) was detected by dichlorofluorescein diacetate (DCFH-DA) . The expression of microtubule-related protein 1 light chain 3 (LC3) was measured by immunofluorescence. The protein level of LC3Ⅱ, p62, Beclin1 and p-AMPK, p-mTOR were detected by Western blot. Results: Compared with the control group, the cell survival rate of the 100, 200, 300, 400 μmol/L PQ group decreased significantly, and showed a dose-dependent pattern (P<0.05) . The survival rate of cells treated with 300 μmol/L PQ decreased significantly with the prolongation of exposure time (12, 24, 48 h) (P<0.05) . Compared with the control group, the activity of LDH in 100, 200, 300 μmol/L PQ-treated group were significantly higher while The fluorescence intensity of ROS was significantly increased (P<0.05) . MDC staining showed the density of autophagic lysosomes and fluorescence intensity in PQ-treated group significantly decreased (P<0.05) . Immunofluorescence results showed the LC3 fluorescence intensity of PQ-treated group decreased which was consistent with MDC staining results. Western blot showed that compared with the control group, the expression levels of autophagy related proteins LC3Ⅱand Beclin1 in PQ-treated group were significantly lower, while the expression level of p62 protein was higher (P<0.05) . p-AMPK protein level decreased and p-mTOR protein expression increased in 200 and 300μmol/L PQ-treatd groups, with statistically significant difference (P<0.05) . Conclusion AMPK-mTOR signaling pathway played a regulatory role in PQ-induced decreased autophagy of PC12 cell.

AIM:To investigate the effect of rhein on bleomycin-induced pulmonary fibrosis and the expression of microRNA-21 (miR-21) and transforming growth factor-β1 (TGF-β1)/Smad signaling molecules in rats.METHODS:A single dose of bleomycin was intratracheal injected into the SD rats to induce pulmonary fibrosis .After injection of bleo-mycin, the rats were randomly divided into low-, medium-and high-dose rhein treatment groups and model group .The rats that were instilled with normal saline intratracheally served as control group .After the treatment for 28 d, the pulmonary pathologic changes were observed under microscope with hematoxylin-eosin staining .The lung coefficient and hydroxypro-line content were also measured .The expression of miR-21 and the mRNA levels of TGF-β1 and Smad7 in the lung tissues were detected by real-time PCR.The protein levels of TGF-β1 and Smad7 were determined by Western blot .RESULTS:Rhein significantly attenuated the experimental alveolitis , pulmonary fibrosis , lung coefficient and hydroxyproline contents in the rats.Rhein obviously decreased the expression of miR-21,and the mRNA and protein levels of TGF-β1, but signifi-cantly increased the mRNA and protein levels of Smad 7 in the lung tissues .CONCLUSION: Rhein effectively prevents bleomycin-induced pulmonary fibrosis by inhibiting the expression of miR-21 and promoting the expression of Smad 7, thus regulating the TGF/Smad signaling pathway to decrease extracellular matrix deposition .