Objective:To evaluate the effect of preventive application of PEG-rhG-CSF on the prevention of neutropenia during concurrent chemoradiotherapy in patients with lung cancer.Methods:A total of 149 patients with lung cancer who received concurrent chemoradiotherapy at Peking University Cancer Hospital from April 2020 to April 2021 were retrospectively analyzed. There were 79 cases in the prevention group, including 48 cases of primary prevention group (preventive application of PEG-rhG-CSF in all concurrent chemoradiotherapy cycles) and 31 cases of secondary prevention group (preventive application of PEG-rhG-CSF in the concurrent chemoradiotherapy cycles after neutropenia occurred). There were 70 cases in non-prevention group. The incidence of grade 3-4 neutropenia, the completion rate of concurrent chemoradiotherapy, the rate of chemoradiotherapy dose reduction and treatment delay, and the rate of hematological toxicities related hospitalization were compared between the prevention group and the non-prevention group.Results:The incidence of grade 3-4 neutropenia in the whole group was 32.2% (48/149), including 6.3% (3/48) in the primary prevention group, 9.7% (3/31) in the secondary prevention group, and 35.7% (25/70) in the non-prevention group. The difference was statistically significant ( χ2=17.81, P<0.001) in the incidence of grade 3-4 neutropenia. The incidence of febrile neutropenia was 3.4% (5/149) in the whole group, but none of them occurred in the primary prevention group. The full completion rate of concurrent chemotherapy was 96.2% (76/79) in the prevention group, which was significantly higher than 82.9% (58/70) in the non-prevention group ( χ2=7.30, P=0.007). The incidence of treatment delayed and dose reduction of chemoradiotherapy was 19.0% (15/79) in the prevention group and 40.0% (28/70) in the non-prevention group, and the difference was statistically significant ( χ2=7.98, P=0.005). Conclusions:The preventive application of PEG-rhG-CSF can effectively reduce the incidence of neutropenia and better ensure the concurrent chemoradiotherapy in lung cancer patients on schedule.

A growing number of studies have identified sex differences in response to general anesthesia; however, the underlying neural mechanisms are unclear. The medial preoptic area (MPA), an important sexually dimorphic structure and a critical hub for regulating consciousness transition, is enriched with estrogen receptor alpha (ERα), particularly in neuronal clusters that participate in regulating sleep. We found that male mice were more sensitive to sevoflurane. Pharmacological inhibition of ERα in the MPA abolished the sex differences in sevoflurane anesthesia, in particular by extending the induction time and facilitating emergence in males but not in females. Suppression of ERα in vitro inhibited GABAergic and glutamatergic neurons of the MPA in males but not in females. Furthermore, ERα knockdown in GABAergic neurons of the male MPA was sufficient to eliminate sex differences during sevoflurane anesthesia. Collectively, MPA ERα positively regulates the activity of MPA GABAergic neurons in males but not in females, which contributes to the sex difference of mice in sevoflurane anesthesia.
Anesthesia ; Animals ; Estrogen Receptor alpha/metabolism* ; Female ; Male ; Mice ; Preoptic Area ; Sevoflurane/pharmacology* ; Sex Characteristics

The minimally invasive cardiovascular surgery developed rapidly in last decades. In order to promote the development of minimally invasive cardiovascular surgery in China, the Chinese Minimally Invasive Cardiovascular Surgery Committee (CMICS) has gradually standardized the collection and report of the data of Chinese minimally invasive cardiovascular surgery since its establishment. The total operation volume of minimally invasive cardiovascular surgery in China has achieved substantial growth with a remarkable popularization of concepts of minimally invasive medicine in 2019. The data of Chinese minimally invasive cardiovascular surgery in 2019 was reported as a paper for the first time, which may provide reference to cardiovascular surgeons and related professionals.

Objective:The standard treatment for inoperable locally advanced esophageal cancer is concurrent chemoradiotherapy, but the survival was not satisfied. Nituzumab is a humanized IgG monoclonal antibody against EGFR. The purpose of this study is to investigate the toxicity and efficacy of concurrent chemoradiotherapy combined with nituzumab for locally advanced esophageal cancer.Methods:We retrospectively reviewed the clinical data of locally advanced esophageal cancer who were treated with concurrent chemoradiotherapy combined with nituzumab in Peking University Cancer Hospital from June 2015 to June 2020. Kaplan- Meier method was used for analysis. Results:Thirty Patients were enrolled this study.After a median follow-up of 22.5 months, The objective response rate was 93%. The 1-year, 2-year, 3-year overall survival rates were 83%, 57% and 41%, with the progression-free survival rates 75%, 47% and 32%, with the local-recurrence free survival rates 83%, 53% and 37%, with the metastasis-free survival rates 75%, 51% and 36%, respectively.The incidence of grade≥3 hematological toxicity was 32%. There were 16% patients experiencing grade≥3 esophagitis.Conclusion:The preliminary result of concurrent chemoradiotherapy combined with nituzumab is effective and safe for patients with locally advanced esophageal cancer.

The lateral hypothalamic area (LHA) plays a pivotal role in regulating consciousness transition, in which orexinergic neurons, GABAergic neurons, and melanin-concentrating hormone neurons are involved. Glutamatergic neurons have a large population in the LHA, but their anesthesia-related effect has not been explored. Here, we found that genetic ablation of LHA glutamatergic neurons shortened the induction time and prolonged the recovery time of isoflurane anesthesia in mice. In contrast, chemogenetic activation of LHA glutamatergic neurons increased the time to anesthesia and decreased the time to recovery. Optogenetic activation of LHA glutamatergic neurons during the maintenance of anesthesia reduced the burst suppression pattern of the electroencephalogram (EEG) and shifted EEG features to an arousal pattern. Photostimulation of LHA glutamatergic projections to the lateral habenula (LHb) also facilitated the emergence from anesthesia and the transition of anesthesia depth to a lighter level. Collectively, LHA glutamatergic neurons and their projections to the LHb regulate anesthetic potency and EEG features.

Objective To analyze the changes in lung function and inflammatory indicators such as eosino-phils(EOS),Creola bodies and exhaled nitric oxide(FeNO),and to explore their value in early diagnosing asthma. Methods One hundred and thirty-five infants with high-risk asthma were selected as an observation group who were admitted to Department of Respiratory,Childrenˊs Hospital of Soochow University from April 2016 to August 2017 due to asthmatic bronchitis and asthmatic bronchopneumonia,and a total of 200 non -asthmatic and non -allergic healthy children who were screened and followed up at the Department of Cardiology in the same period were selected as a healthy control group for the measurement of moist respiratory lung function and FeNO. In the observation group,the bronchial dilation test(BDT),EOS and Creola bodies were performed simultaneously. Classification of lung function:23%≤time to peak ratio(TPTEF/Te)<28% had mild obstruction,15%≤TPTEF/Te<23% had moderate obstruc-tion,and TPTEF/Te<15% showed severe obstruction. Results The TPTEF/Te[17. 20%(8. 10%)],volume to peak ratio(VPEF/Ve)[21. 20%(6. 20%)],tidal volume per kilogram of body weight(VT/kg)[7. 80(3. 70)]and ratio of tidal expiratory flow 25% to peak tidal expiratory flow(25/PF)[0. 54(0. 20)]in the observation group were signifi-cantly lower than those in the healthy control group[22. 30%(9. 22%),27. 15%(7. 10%),8. 90(3. 17),0. 60 (0. 18)],and the differences were statistically significant(Z＝ -6. 81,-9. 35,-3. 16,-3. 52,all P<0. 05). BDT positive rate in the mild obstruction group was 20. 00%(3/15 cases),BDT positive rate in the moderate obstruction group was 26. 56%(17/64 cases),and BDT positive rate in the severe obstruction group was 48. 72%(19/39 cases). The higher the degree of obstruction,the higher the value of BDT positive diagnosis(F＝6. 353,P<0. 05). BDT of VPEF/Ve,25/PF and TPTEF/Te were consistent and statistically significant(Kappa＝0. 78,0. 49,all P<0. 001). Ti-dal expiratory flow 50% -remaining(TEF50% -r)[(117. 86 ± 42. 16)mL/s],tidal expiratory flow 25% -remai- ning(TEF25% -r)[(82. 82 ± 35. 44)mL/s]in the second wheezing group were higher than those in the first whee-zing group[(92. 81 ± 28. 40)mL/s,(65. 22 ± 24. 93)mL/s],and the differences were statistically significant( t＝3. 34,2. 77,all P <0. 05). There was no statistically significant difference in sputum EOS,FeNO and Creola body scores among wheezing children between the first and second groups(all P>0. 05). FeNO in the observation group [3. 80(5. 43)μg/L]was significantly lower than that in the healthy control group[9. 60(11. 3)μg/L],and the diffe-rence was statistically significant(Z＝14. 56,P<0. 05). Sputum EOS had a positive correlation with blood EOS and Creola bodies(r＝0. 20,0. 21,all P<0. 05);there was no correlation between lung function parameters and inflamma-tory indices(all P>0. 05). Conclusions In the acute phase of infant asthma attack,the pulmonary function presents different degrees of obstructive ventilation dysfunction,the higher the degree of obstruction,the higher the diagnostic value of BDT. The value of single FeNO measurement is limited,and continuous dynamic monitoring may be more mea-ningful in predicting the occurrence of asthma. Detection of Creola bodies may be helpful in predicting asthma.

Objective To evaluate whether the thalamic paraventricular nucleus mediates orexiner-gic ( orexin ) neurons-induced promotion of emergence from general anesthesia by using the optogenetics method in mice. Methods Twenty healthy male Hcrt-cre mice, aged 8-10 weeks, weighing 20-25 g, were divided into 4 groups ( n=5 each) using a random number table method: retrograde labeled viruses channelrhodopsin group ( R group) , anterograde labeled viruses channelrhodopsin group ( A group) , retro-grade labeled viruses control group ( RC group ) , and anterograde labeled viruses control group ( AC group) . The optogenetics technique was used in each group. Anesthesia was induced and maintained through inhaling 1％ isoflurane and pure oxygen 1. 0 L∕min. Electroencephalogram was monitored througout the procedure with the PowerLab monitoring system. The burst suppression ratio ( BSR) was recorded at 1 min before light stimulation and during light stimulation. Results Compared with RC group or the baseline at 1 min before light stimulation, the BSR was significantly decreased during light stimulation in R group ( P<0. 05) . Compared with AC group or the baseline at 1 min before light stimulation, the BSR was signifi-cantly decreased during light stimulation in group A ( P<0. 05) . Conclusion Optogenetics technique ap-plication once again confirms that orexin neurons can promote emergence from general anesthesia through thalamic paraventricular nucleus in mice.

Objective To investigate the effect of the endoscopic surveillance system in irrigating fluid absorption and bleeding during transurethral resection of the prostate.Methods In vitro trials,we simulated the fluid absorption and bleeding in the operation by using self-developed endoscopic surveillance system from January 2013 to June 2013.Continuous irrigation of 5 ％ mannitol solution,we extracted 5 times irrigating fluid (each time 100 ml and a total of 500 ml) in the process of irrigation and recorded absorption measurements of every time extraction rinses.At the same time,we dripped human whole blood 5 times(each time 5 ml and a total of 25 ml) in the process of irrigation and recorded the bleeding measurements.The above process was repeated three times to detect the accuracy and consistency of the endoscopic surveillance system.In clinical trials,50 cases of BPH were monitored in surgery and the biochemical index,hemodynamics,irrigating fluid absorption and bleeding were compared from October 2016 to April 2017.The included criteria contained as follow:the age of patients should be more than 50 years.The transabdominal ultrasound showed that the volume of prostate should be more than 60 ml.The maximal uroflowmetry should be less than 15ml/s.The IPSS scores should be more than 8.Based on the operative time,two groups (＜60 min and ≥ 60 min) were classified.Results We developed the endoscopic surveillance system which is original in the world.In vitro trials,the average irrigating fluid were (100.60 ± 2.07) ml,(201.00±3.39) ml,(302.00±4.67) ml,(403.60±4.39) ml and (502.40 ±7.57) ml;and the average bleeding were (5.06 ± 0.11) ml,(10.10 ± 0.16) ml,(15.04 ± 0.15) ml,(20.06 ± 0.11) ml and (25.10 ± 0.16) ml.No significant difference was observed in all groups (P ＞ 0.05).In clinical trials,we compared some preoperative and postoperative indexes.The average blood oxygen saturation were (94.46 ± 2.49) ％ and (92.39 ± 2.77) ％ (P ＜ 0.01),the average Serum sodium ion concentration were (141.05 ± 2.52) mmol/L and (138.06 ± 4.27) mmol/L(P ＜ 0.01),the average HGB were (143.50 ± 13.43) g/L and (137.04 ± 14.25) g/L(P ＜ 0.01).The average HCT were (42.05 ± 4.09) ％ and (137.04 ± 14.25) ％ (P ＜ 0.01).The average HR were (77.9 ± 7.6) beats per minute and (77.93 ± 6.93) beats per minute (P＞0.05).The MAP were (90.32 ± 9.75) mmHg and (91.07±8.96)mmHg(P＞0.05).The average serum potassium ion concentration were (4.13 ± 0.53) mmol/L and (4.09 ± 0.37) mmol/L (P ＞ 0.05).The average irrigating fluid absorption of the group less than 60 minutes and the group equal or more than 60 minutes were (401.83 ± 279.23) ml and (885.25 ± 367.68) ml (P ＜ 0.01).The average blood loss were (64.10 ±47.47) ml and (158.40 ± 65.22) ml(P ＜0.01).The preoperative and postoperative hemodynamic,blood biochemical and hematology showed difference in our trials.Irrigating fluid absorption and blood loss were positively associated with operation time.Conclusions The endoscopic surveillance system was safety and accuracy.It can offer real-time monitoring data and alarm mechanism for the surgeons that possibly improve operation safety.

Triple-negative breast cancer,which lacks estrogen receptor,progesterone receptor,and human epidermal growth factor receptor 2,accounts for about 15％-20％ of breast cancers,and is the most aggressive breast cancer subtype.It displays poor prognosis from traditional therapies,therefore,there is an urgent need to find new treatments.This paper mainly describes the characteristics of protein and gene expression,such as PIM1,MYC,CDK4,TGF-β,TP53,MYOF,FOSB,MENA,and the latest research of therapeutic approaches of triplenegative breast cancer about PARP,PI3K/Akt/mTOR,EGFR,Hedgehog,Met,etc..

Objective To provide new experimental evidences associated with the mechanisms of inhaled anesthetics, the effects of sevoflurane on the electric activities of inhibitory interneurons in basal forebrain area (BF) were observed.Methods C57BL/6 mice, aged 2-3 weeks, were used and BF sections were cut for whole patch-clamp recording.Artificial cerebrospinal fluid containing sevoflurane was given and action potential, inhibitory postsynaptic potential were recorded.Results Sevoflurane could increase the frequency of firing rate of inhibitory interneurons in basal forebrain area (P<0.001), which could increase the frequency of action potential caused by depolarization current (P<0.05), and increase the frequency of spontaneous inhibitory postsynaptic currents of pyramidal neurons (P<0.05), while AP-depended miniature inhibitory postsynaptic currents were not significantly changed.Conclusion The basal forebrain inhibitory interneurons are involved in the anesthetic effect of sevoflurane.