Objective:To explore the effect of perioperative aspirin administration on intraoperative and postoperative bleeding in patients undergoing video-assisted thoracoscopic (VATS) pulmonary wedge resection.Methods:Sixty-three patients scheduled for VATS pulmonary wedge resection in Shougang Hospital of Peking University from November 2020 to April 2022 were randomly assigned in 2 groups. All patients had a history of aspirin taking, patients in study group ( n=32) continued aspirin taking perioperatively, and patients in the control group ( n=31) stopped taking aspirin for 7 days before surgery and resumed taking 3 days after surgery. The volume of intraoperative blood lost, operation time, postoperative drainage volume, thoracic drainage tube placement time, postoperative hospital stay, postoperative thrombosis of lower extremity, perioperative cardiovascular and cerebrovascular events, and postoperative wound healing were documented and compared between the two groups. Results:There were no significant differences in age, gender, oral aspirin time, lesion location, lesion nature, localization, lesion size and underlying disease between the two groups (all P>0.05). All patients successfully completed the operation, and no patients switched to thoracotomy. The intraoperative blood loss in study group and control group was (27.72±12.86) ml and (31.35±13.81) ml ( t=1.08, P=0.283); the operation time was (61.16±10.24) minutes and (61.39±13.79) minutes, respectively ( t=0.08, P=0.940). There were no significant differences in postoperative thoracic drainage, drainage tube placement time, length of hospital stay, incidence of lower extremity thrombosis, incidence of cardiovascular and cerebrovascular events, and rate of poor wound healing between the two groups (all P>0.05). Conclusion:Perioperative administration of aspirin may not increase intraoperative and postoperative bleeding, and the incidence of operation-related complications in patients undergoing VATS pulmonary wedge resection.

Objective To investigate the relationship between sleep duration and obesity, and the risk of common chronic diseases in the occupational population in Shanghai City. Methods A total of 18 775 occupational individuals were selected as the study subjects using convenience sampling method in Shanghai City. Data on personal lifestyle behaviors and medical examination results were collected. The relationship between sleep duration and different types of obesity with dyslipidemia, hyperuricemia, hypertension, and hyperglycemia was analyzed. Results The incidence of dyslipidemia, hyperuricemia, hypertension, and hyperglycemia among the study subjects was 24.9%, 16.2%, 11.5%, and 7.3%, respectively. The incidence of these four chronic diseases were higher in individuals with central obesity and suboptimal sleep compared to the control group (all P<0.01). Multivariate logistic regression analysis showed that suboptimal sleep combined with general obesity/overweight increased the risk of dyslipidemia, hyperuricemia, hypertension, and hyperglycemia in the study subjects ［odds ratio (OR) were 2.40, 3.47, 3.30, and 2.79, respectively; all P<0.01］, after adjusting for age, gender, education level, marital status, occupation type, labor intensity, smoking, and drinking. Suboptimal sleep combined with central obesity also potentially increased the risk of these four chronic diseases (OR were 2.25, 3.09, 3.09, and 2.98, respectively; all P<0.01). Conclusion The incidence of common chronic diseases is relatively high in the occupational population in Shanghai City. Suboptimal sleep combined with different types of obesity increases the risk of common chronic diseases.

Objective:To summarize and analyze the clinical data of Chinese patients with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy, and clarify the phenotypic and genetic characteristics of Chinese patients.Methods:Medical history of patients with CSF1R-related leukoencephalopathy diagnosed from April 1, 2018 to January 31, 2021 in the department of neurology of 22 hospitals in China was collected, and scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), magnetic resonance severity scale were evaluated. Group comparison was performed between male and female patients.Results:A total of 62 patients were included, and the male-female ratio was 1∶1.95. The age of onset was (40.35±8.42) years. Cognitive impairment (82.3%, 51/62) and motor symptoms (77.4%,48/62) were the most common symptoms. The MMSE and MoCA scores were 18.79±7.16 and 13.96±7.23, respectively, and the scores of two scales in male patients (22.06±5.31 and 18.08±5.60) were significantly higher than those in females (15.53±7.41 , t=2.954, P=0.006; 10.15±6.26, t=3.328 , P=0.003). The most common radiographic feature was bilateral asymmetric white matter changes (100.0%), and the magnetic resonance imaging severity scale score was 27.42±11.40, while the white matter lesion score of females (22.94±8.39) was significantly higher than that of males (17.62±8.74 , t=-2.221, P<0.05). A total of 36 CSF1R gene mutations were found in this study, among which c.2381T>C/p.I794T was the hotspot mutation that carried by 17.9% (10/56) of the probands. Conclusions:The core phenotypic characteristics of CSF1R-related leukoencephalopathy in China are progressive motor and cognitive impairment, with bilateral asymmetrical white matter changes. In addition, there exist gender differences clinically, with severer cognitive impairment and imaging changes in female patients. Thirty-six CSF1R gene mutations were found in this study, and c.2381T>C/p. I794T was the hotspot mutation.

Objective To explore the role of balloon-assisted coil embolization for ruptured wide-necked posterior communicating aneurysms in elderly patients. Methods Twenty-nine elderly patients with ruptured wide-necked posterior communicating aneurysms, admitted to and accepted balloon-assisted coil embolization in our hospital from September 2016 to December 2017, were chosen in our study. Eighteen patients had 0-2 of modified Rankin scale (mRS) scores on admission, 7 had 3 scores, and 4 had 4 scores. Twenty-one patients had Hunt-Hess grading I-II, and 8 had Hunt-Hess grading III-IV. Clinical data and treatment efficacy of the patients were retrospectively analyzed. Results Twenty-eight aneurysms were embolized successfully by balloon-assisted coil technique; one aneurysm due to unstable coil frame was treated by stent remolding. Raymond grading 1 was noted in 25 aneurysms and Raymond grading 2 in 4 aneurysms according to immediate post-embolization angiographic results. The mRS scores were 0-2 in 24 patients, 3 in 2 patients and 4 in one patient. Two patients died from systemic diseases (acute pneumonia with diabetic ketoacidosis and heart stroke). Three patients had complications associated with operation, including one with intraoperative aneurysmal rupture, one with laterality limb weakness, and one with contralateral limb paralysis; all recovered after treatment. Conclusion The balloon-assisted coil embolization is safe and effective for coil embolization for ruptured wide-necked posterior communicating aneurysms in elderly patients.

[Abstrict]Objective To explore the key points and clinical value of combined direct and indirect extracranial-in?tracranial (EC-IC) bypass in patients with adult moyamoya disease. Methods Retrospective analysis of combined revas?cularization surgery in 25 adult patients with moyamoya disease. The frontal branch and parietal branch of the superficial temporal artery (STA) were dissected. Combined revascularization surgery consisted of direct (anastomosis between the su?perficial temporal artery and cortical branch of the middle cerebral artery) and indirect (encephalodurogaleosynan-giosis EDAS) surgeries. Clinical status was evaluated using the modified Rankin Scale and NIHSS score at 1 day before, 1 week and 3 months after surgery. Results Thirty lateralities were successfully performed on 25 patients. Postoperative angiogra?phy or CTA and cranial computer tomography perfusion imaging(CTP) were conducted to examine the patency of the di?rect anastomosis and cerebral blood flow in 23 patientswithin 1 weeks after surgery . The results showed that the anasto?motic vascular patency was excellent and the cerebral blood flow increased in parallel to the relief of the patients’s isch?emic symptoms. The median mRS scores were 3 (1,3) before surgery, 2 (1,3) 1 week and 1 (0,3) 1 month after surgery.The median mRS scores were significantly improved (Z=15.14, P<0.01). The median NIHSS scores was 5 (4,8) preopera?tively and 4(2,7) postoperation 1 week and 3(1,4) 3 months. The median NIHSS scores were also significantly improved (Z=11.36, P<0.01). Unfortunately, two patients had complication and left hemiparesis. One patient complicated with con?tralateral hemisphere infarction and the another one complicated with ipsilateral hemispheric hemorrhage after operation. Conclusions Combined revascularization surgery may result in satisfying improvement in clinical, angiographic, and he?modynamic states and prevention of recurrent stroke. The stabilized hemodynamic is the key point in peroperative period for moyamoya patients.

Objective:To establish a method based on the iPLEX analysis of MassARRAY mass spectrometry platform to detect multiplex genetic mutations among Chinese lung cancer patients. Methods:We reviewed the related literature and data of lung cancer treatments. We also determined 99 mutation hot spots in 13 target genes, namely, EGFR, KRAS, ALK, FGFR1, FGFR2, FGFR3, PIK3CA, BRAF, PTEN, MET, ERBB2, AKT1, and STK11, which are closely related to the pathogenesis, drug resistance, and metastasis of lung cancer and are associated with relevant transduction pathways. A total of 297 primers comprising 99 paired forward and reverse amplification primers and 99 matched extension primers were designed by using Assay Design in accordance with the mutation label and format requirements of the MassARRAY platform. The detection method was established by analyzing eight cell lines and six lung cancer specimens;the proposed method was then validated through comparisons with a LungCarta kit. The sensitivity and specificity of the proposed method were evaluated by directly sequencing EGFR and KRAS genes in 100 lung cancer cases. Results:The proposed method could detect multiplex genetic mutations in the lung cancer cell lines, and this finding is consistent with that observed using previously reported methods. The proposed method could also detect such mutations in clinical lung cancer specimens;this result is also consistent with that observed by using the LungCarta kit. However, an FGFR2 mutation was detected only by using the proposed method. The measured sensitivity and specificity were 100%and 96.3%, respectively. Conclusion:The proposed MassARRAY technology-based method could detect multiplex genetic mutations among Chinese lung cancer patients. Indeed, the proposed method can be potentially applied to detect mutations in cancer cells.

A total of 105 patients with first-episode schizophrenia (male =51,female =54) and 99 normal controls (male =51,female =48) were included into this retrospective case-control study.Childhood trauma questionnaire-28 item short form (CTQ-SF) was used to assess the experience of childhood abuse.The result of binary logistic regression showed that emotional abuse (β =0.630,P ＜ 0.05) and emotional neglect(β =0.270,P ＜ 0.05) were included into the final model of predicting schizophrenia.It indicates that patients with first-episode schizophrenia experienced more early life stress than controls.Particularly emotional abuse and emotional neglect may play important roles in the onset of schizophrenia.

ObjectiveTo investigate the fusion sequence complexity of EML4-ALK in non-small cell lung cancer (NSCLC) patients,and the potential mutation in tyrosine kinase ( TK ) domain of ALK gene.MethodsIn routine practice,a novel echinoderm microtubule-associated protein-like4 and anaplastic lymphoma kinase (EML4-ALK) V3c variant was detected by rapid amplification of cDNA ends-polymerase chain reaction ( RACE-PCR )-sequencing technology in a patient with NSCLC.The further consecutive 39 cases( total of 40 cases)were screened by use of reverse transcription (RT)-PCR for EML4-ALK fusion.Positive PCR products were purified and cloned into T vectors,transformed into DH5a germ cells and colony picked up and sequenced for sequence complexity analysis.Tyrosine kinase domain of ALK was amplified by RT-PCR and sequenced.ResultsThree out of 40 cases had EML4-ALK fusion.One case had six novel variants of EML4-ALK co-existing,termed as V3c ( 64.6％ ),V3d ( 25.0％ ),V3e ( 2.1％ ),V3f (4.2％ ),V3g(2.1％ )and V3h(2.1％ ) variants,whereas without common V3a and V3b variants.In other two positive cases,one was V1 variant,another was concurrent V2,V3a and V3b variants.No mutations were detected in the TK domain of EML4-ALK in any case.ConclusionsSeveral EML-ALK variants could co-exist in a given lung cancer tissue,which suggest that the diversity and sequence complexity of EML4-ALK fusion are exist.Attentions should be paid to screen all the variants in clinic to improve the pick-up rate.

Objective To study the effect of long-time carbon dioxide (CO2) pneumoperitoneum on QT dispersion (QTd) in elderly patients during Davinci robotassisted surgery.Methods Thirty elderly patients undergoing elective Davinci robot-assisted hepato-pancreato-biliary surgery with general anesthesia were enrolled in this study.Pneumoperitoneum was established at 12 mm Hg ( 1 mm Hg =0.13 3 k Pa).QTd was recorded before the induction of anesthesia; at 5,15,30,60,120,180 and 240 min after pneumoperitoneum.Results Compared with before anesthesia,mean arterial blood pressure (MAP) increased significantly at 15,30 min after pneumoperitoneum ( P＜0.05 ),and had no significant difference at 5,60,120,180,240min (P＞0.05 ).Heart rate (HR) increased significantly at 15,30 min after pneumoperitoneum (P＜0.05 ).End-tidal pressure of carbon dioxide (PETCO2) increased after pneumoperi-toneum,and had significant difference at 30,60,120,180,240 min after pneumoperitoneum (P＜0.05).In 30 patients,11 patients occurred arrhythmia including atrial extrasystole,premature ventricular beats,tachycardia.Compared with before anesthesia,QTd,corrected QTd (QTcd),QT interval,corrected QT interval (QTe) were significantly increased at 15,30,60 min after pneumoperitoneum (P＜0.05),but had on significant difference at 5,120,180,240 min after pneumoperitoneum (P＞0.05).Conclusion The effect of CO2 pneumoperitoneum on the autonomic nervous system for elderly patients might be important,as an imbalance in autonomic cardiac control might lead to serious consequences.

Objective To explore the effect of application of continue performance test (CPT) in screening of attention deficit hyperactivity disorder( ADHD ). Methods Thirty-five children with ADHD and65 normal children had been applied with CPT and Conner questionnaire test. Used rank sum test to examine the outcome, established receiver operating characteristic (ROC) curve, analyzed the most valuable index among various data, formulated abnormal critical value, and carried on a consistency check between CPT screening outcome and clinical diagnosis outcome. Results Each CPT index of 35 children with ADHD was obviously higher than those of normal children(P＜ 0.05 ). Most indexes' area under the ROC curve exceeded 0.7, reactive time of VST was the highest among each index which achieved 0.915. It was high conformity between CPT screening outcome and clinical diagnosis outcome (Kappa = 0.935 ). Conclusion CPT can be applied in ADHD screening.