Objective To investigate the epidemiological survey of pulmonary Aspergillus infection in a district of Hefei City, Anhui Province, from 2019 to 2023. Methods The data of 302 patients who attended and were treated in the respiratory department, thoracic surgery department, oncology department, tuberculosis department and RICU ward of Anhui Chest Hospital from January 2019 to September 2023 were selected, and patients with Aspergillus infections were taken as the observation group, patients with Candida infections were taken as the control group, and bacterial infections were taken as the blank group. The general information of patients, pre-treatment infection, underlying diseases, and use of antifungal drugs were analyzed. Compare the data of observation group and control group, and analyze the risk factors affecting pulmonary Aspergillus infection. Results Pulmonary Aspergillus infection 100 cases, accounting for 33.11%. Pulmonary Candida infection was 80 cases, accounting for 26.49%. The other 122 cases were other lung diseases, accounting for 40.40%. The most common causative agent of pulmonary Aspergillus infection was Aspergillus fumigatus (57.00%), cough, sputum and occasional blood were found in most of the patients (88.00%), most of the lesions were located in the right upper lobe of the lungs (55.00%), and most of the single or multiple cavities were seen on imaging (47.00%). Specimens mostly originated from the deep airways of hospitalized patients and there was a predominance of male patients. Risk factors for pulmonary Aspergillus infection were history of hospital transfer, ICU admission, mechanical ventilation, extracorporeal catheterization (intravenous catheter and urinary catheter), history of surgery within 15 days, history of diabetes mellitus, history of respiratory chronic disease, history of antifungal prophylaxis and abnormal serum indicators. History of hospital transfer (OR=2.951, P=0.008), history of diabetes mellitus (OR=5.073, P=0.018), history of chronic respiratory disease (OR=7.523 , P=0.028), extracorporeal catheterization (OR=3.142, P=0.022), and history of anti-fungal prophylaxis (OR=6.334, P<0.001) were Aspergillus pulmonaryis infection independent risk factors for infection. Conclusion Aspergillus fumigatus and Aspergillus flavus are the main pathogens of pulmonary Aspergillus infections in the region, and a history of nosocomial transfer, extracorporeal tubes, diabetes mellitus, chronic respiratory disease, and antifungal prophylaxis are independent risk factors for pulmonary Aspergillus infections.

[摘 要] 目的：探究双特异性磷酸酶26（DUSP26）在肺腺癌（LUAD）A549细胞增殖、迁移和侵袭中的作用及其分子机制。方法：检索肿瘤数据库GEPIA2网站DUSP26表达数据，分析DUSP26在LUAD患者和正常人肺组织中的表达差异。收集2022年10月至2023年10月期间萍乡市人民医院手术切除的12例LUAD组织和癌旁组织标本，通过免疫组织化学（IHC）和WB法检测DUSP26在LUAD组织和癌旁组织之间的表达差异；通过WB法检测DUSP26在4种LUAD细胞（A549、SK-LU-1、Calu-3、H1299）和2种正常支气管上皮细胞（BEAS-2B、HBEC）中的表达差异。利用慢病毒转染细胞的方法构建稳定过表达DUSP26（DUSP26-OE）及阴性对照（DUSP26-OENC）的A549细胞，通过克隆形成、划痕愈合实验、Transwell实验分别检测DUSP26过表达对细胞增殖、迁移及侵袭能力的影响，WB法检测各组细胞中TGF-β1/SMAD2/3通路、EMT相关蛋白的表达水平，细胞免疫荧光法检测细胞中Ki-67、cyclin D1表达水平。加入TGF-β1重组蛋白进行回复实验。构建A549细胞裸鼠荷瘤模型，观察DUSP26过表达对移植瘤体内生长的影响，WB法检测移植瘤组织中TGF-β1/SMAD2/3通路、EMT相关蛋白表达水平，免疫荧光染色法检测移植瘤组织中Ki-67、cyclin D1表达水平。结果：DUSP26在LUAD组织和细胞中均呈低表达（P < 0.05或P < 0.01或P < 0.001或P < 0.000 1）。与DUSP26-OENC组相比，DUSP26-OE组A549细胞的增殖、迁移和侵袭能力均显著降低（P < 0.01或P < 0.001），TGF-β1、p-SMAD2/3、vimentin、N-cadherin、snail、Ki-67、cyclin D1表达均降低（P < 0.01或P < 0.001或P < 0.000 1），E-cadherin表达升高（P < 0.000 1）。加入5 ng/mL TGF-β1重组蛋白后，可部分逆转在体外实验中由DUSP26过表达导致的结果。成功构建裸鼠A549细胞荷瘤模型，DUSP26-OE组裸鼠移植瘤生长速度缓慢，体积和质量均减小（均P < 0.001），移植瘤组织中TGF-β1、p-SMAD2/3、vimentin、N-cadherin、snail、Ki-67、cyclin D1表达均降低（P < 0.01或P < 0.001），E-cadherin表达升高（P < 0.000 1）。结论：DUSP26在LUAD组织和细胞中均呈低表达状态，上调DUSP26的表达水平能够通过抑制TGF-β1/SMAD2/3信号通路抑制A549细胞的增殖、迁移和侵袭。

Fracture is a common orthopedic disease in clinical practice,and the resulting nonunion or delayed union of frac-tures is a major challenge in clinical treatment.In the process of fracture healing,there is a complex interaction between angio-genesis and osteogenesis,which is called the"angiogenesis-osteogenesis coupling"mechanism.In recent years,a new capillary subtype characterized by high expression of platelet endothelial cell adhesion molecule-1(PECAM-1/CD31)and salivary glyco-protein(EMCN),namely type H blood vessel,has been identified and found to play an important role in regulation of the angio-genesis-osteogenesis coupling.In this review,the mechanism of type H blood vessels promoting angiogenesis-osteogenesis cou-pling,the related molecules and signal pathways regulating type H blood vessels regeneration were discussed,in order to provide new ideas and methods for promoting fracture healing.

Background::Hypothermia therapy has been suggested to attenuate myocardial necrosis; however, the clinical implementation as a valid therapeutic strategy has failed, and new approaches are needed to translate into clinical applications. This study aimed to assess the feasibility, safety, and efficacy of a novel selective intracoronary hypothermia (SICH) device in mitigating myocardial reperfusion injury.Methods::This study comprised two phases. The first phase of the SICH was performed in a normal porcine model for 30 minutes ( n = 5) to evaluate its feasibility. The second phase was conducted in a porcine myocardial infarction (MI) model of myocardial ischemia/reperfusion which was performed by balloon occlusion of the left anterior descending coronary artery for 60 minutes and maintained for 42 days. Pigs in the hypothermia group ( n = 8) received hypothermia intervention onset reperfusion for 30 minutes and controls ( n = 8) received no intervention. All animals were followed for 42 days. Cardiac magnetic resonance analysis (five and 42 days post-MI) and a series of biomarkers/histological studies were performed. Results::The average time to lower temperatures to a steady state was 4.8 ± 0.8 s. SICH had no impact on blood pressure or heart rate and was safely performed without complications by using a 3.9 F catheter. Interleukin-6 (IL-6), tumor necrosis factor-α, C-reactive protein (CRP), and brain natriuretic peptide (BNP) were lower at 60 min post perfusion in pigs that underwent SICH as compared with the control group. On day 5 post MI/R, edema, intramyocardial hemorrhage, and microvascular obstruction were reduced in the hypothermia group. On day 42 post MI/R, the infarct size, IL-6, CRP, BNP, and matrix metalloproteinase-9 were reduced, and the ejection fraction was improved in pigs that underwent SICH.Conclusions::The SICH device safely and effectively reduced the infarct size and improved heart function in a pig model of MI/R. These beneficial effects indicate the clinical potential of SICH for treatment of myocardial reperfusion injury.

Objective:To discuss the effect of temperature-controlled shrinkage polytrimethylene carbonate(PTMC)/polyvinylpyrrolidone(PVP)nanofiber membrane on the biological behavior of mouse fibroblasts and the repairment effect on full-thickness skin defects in the rats,and to clarify the potential mechanism.Methods:The murine L929 fibroblast cells were used in the in vitro experiments and were divided into control group and experimental group(treated with PTMC/PVP nanofiber membranes).The proliferation activities of the cells in two groups were detected by CCK-8 assay;the numbers of live/dead cells in two groups were observed by live/dead cell staining;the morphology of the cells was observed by cytoskeletal staining.A total of 12 six-week-old male SD rats were selected in the in vivo experiment,and were randomly divided into control group and experimental group,and there were six rats in each group.The full-thickness skin defect model was established,and the rats in experimental group were treated with PTMC/PVP nanofiber membranes.The photographs were taken after operation,and the wound healing rates of the cells in two groups were calculated on the 0,3rd,6th,and 12th days.On the 6th and 12th days after operation,the skin samples around the wound of the rats in two groups were taken,and the histopathology of the would skin and adjacent tissue was detected by HE staining;the collagen deposition in wound skin tissue of the rats in two groups was observed by Masson trichrome staining;the numbers of angiogenesis in wound skin tissue of the rats were detected by CD31 immunohistochemical staining.Results:The CCK-8 assay results showed that the proliferation activity of the cells in experimental group showed an increasing trend on the 1st,3st,and 5st days,and there was no significant difference in the proliferation activities of the cells bewteen experimental group and control group(P＞0.05).The live/dead cell staining experiment results showed that compared with control group,the cell density and number of the cells in experimental group had no significant changes,and were predominantly live cells.The cytoskeletal staining results showed that the cells in experimental and control groups appeared spindle-shaped and well-spread.In the in vivo experiments,on the 3rd,6th,and 12th days,compared with control group,the wound healing rates of the cells in experimental group were increased(P＜0.01),and the wound healing rate of the cells was 95.45％on the 12th day,indicating nearly complete healing of the wound.The HE staining showed that on the 12th day,the wound skin structure of the cells in experimental group was more similar to the normal skin,and there was abundant granulation tissue,regular epidermal structure,and new blood vessel formation.The Masson trichrome staining results showed that compared with control group,the collagen deposition in wound tissue of the rats in experimental group was increased.The immunohistochemical staining results showed that the expression of CD31 in wound tissue of the rats in experimental group was increased,indicating the increasing of the number of angiogenesis.Conclusion:The PTMC/PVP thermoresponsive nanofiber membranes exhibit good biocompatibility and can promote the repairment of full-thickness skin defects in the rats;its mechanism may be related to the enhancement of proliferation activity of the basal cells.

Objective To explore the effect of Lee-Silverman voice treatment (LSVT) on language re-habilitation of dysarthria in Parkinson's disease (PD).Methods A total of 84 patients with PD dysarthria ad-mitted to our hospital from February 2019 to February 2022 were selected as the research objects.According to the random number table method,they were divided into observation group and control group,with 42 cases in each group.The control group received routine speech rehabilitation training,and the observation group re-ceived LSVT for four weeks.The scores of Western Aphasia Battery (WAB) and Aphasia Quotient (AQ) be-fore and after intervention were compared between the two groups,and the differences of electroglottographic parameters such as jitter,F0,shimmer,normalized noise energy (NNE) and harmonic noise ratio (HNR) were compared between the two groups.Results Before intervention,there was no significant difference in WAB scores (listening comprehension,repetition,spontaneous speech,naming) and AQ scores between the two groups (P>0.05).After intervention,the above scores of the two groups were significantly improved,and the observation group was higher than the control group,the difference was statistically significant (P<0.05). Before intervention,the jitter,F0,shimmer,NNE,HNR of vowels "a""i""u" in the two groups were not sta-tistically significant (P>0.05).After intervention,the above-mentioned electroglottic parameters of the two groups were significantly improved.The jitter and NNE of vowels "a""i""u" in the observation group were lower than those in the control group,and the HNR was higher than that in the control group,the differences were statistically significant (P<0.05).Conclusion LSVT can improve the electroglottographic parameters and speech function of patients with PD dysarthria,and the language rehabilitation effect of PD dysarthria is obvious.

Objective To investigate the value of quantitative CT(QCT)parameters related to abdominal and dorsal fat content for predicting early postoperative complications of esophageal cancer.Methods A total of 184 patients who underwent radical esophageal cancer surgery were retrospectively collected and divided into complication group(n=76)and control group(n=108)according to whether early postoperation complication(within 30 days after surgery)occurred or not.QCT was used to obtain parameters related to abdominal and dorsal fat content,including visceral fat area(VFA),subcutaneous fat area(SFA),VFA/SFA and the degree of muscle fat infiltration(MFI)of posterior vertebral muscles based on L3 central-level CT images.Univariate analysis and multivariate logistic regression were used to analyze clinical and pathological data as well as QCT parameters related to abdominal and dorsal fat content to screen independent risk factors for early postoperative complications of esophageal cancer.Then receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each independent risk factor alone and their combination for predicting early postoperative complications of esophageal cancer.Results VFA/SFA and MFI degree of posterior vertebral muscles were both independent risk factors for early postoperative complications of esophageal cancer(OR=5.121,1.110,both P＜0.05).The AUC of VFA/SFA and MFI degree of posterior vertebral muscle was 0.81 and 0.77,respectively,while of their combination was 0.84.Conclusion QCT parameters related to abdominal and dorsal fat content could be used to effectively predict early complications of esophageal cancer after surgery.

Objective:To investigate the clinical effect of artificial intelligence(AI)technique in delineating target volume for patients with lung cancer during radiotherapy.Methods:A total of 60 patients with lung cancer who received radiotherapy in Pingxiang People's Hospital from September 2021 to March 2023 were selected,and they were divided into control group and observation group by random envelope method,with 30 cases in each group.The control group outlined target volume as conventional method.The observation group adopted deep learning technique to conduct train,and then,UNet network model was output and was used to complete automatic delineation for the target volume of radiotherapy for patients.The near-term efficacy,planning target region volume,radiation dose of target volume,volume and dose of organ at risk(OAR),survival time and incidence of adverse reactions were compared between two groups.Results:The objective relief rate(ORR)of observation group was 70.0％(21/30)after intervention,which was higher than that[46.67％(14/30)]of control group,and the difference was statistically significant(x2=5.691,P＜0.05).The radiation doses of internal target volume(ITV)and planning target volume in observation group were lower respectively than those in control group(t=4.591,4.934,P＜0.05),and the differences of them were significant,respectively.The volume percentages(V20,V5)of the exposed radiation dose that were higher than 20 Gy and 5 Gy in normal lung tissue,the exposed mean lung dose(MLD)of bilateral lungs and the exposed dose of 1cc volume(D1cc)of bilateral lungs in observation group were all lower than those in control group,the differences were statistically significant(t=5.249,4.571,6.092,5.339,P＜0.05),respectively.There was no statistical significance in the incidence of adverse reaction between two groups(P＞0.05).Conclusion:The application of AI technique in delineating target volume of radiotherapy for lung cancer can improve ORR,which is helpful to decrease the planning target volume,D95 and conformal index,and reduce the volume and dose of OAR.It does not increase the incidence of adverse reactions.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.