Background: Intraoperative hypercapnia reduces the time to emergence from volatile anesthetics, but few clinical studies have explored the effect of hypercapnia on the emergence time from intravenous (IV) anesthesia. We investigated the effect of inducing mild hypercapnia during the recovery period on the emergence time after total IV anesthesia (TIVA). Methods: Adult patients undergoing transurethral lithotripsy under TIVA were randomly allocated to normocapnia group (end-tidal carbon dioxide [ETCO2] 35–40 mmHg) or mild hypercapnia group (ETCO2 50-55 mmHg) during the recovery period. The primary outcome was the extubation time. The spontaneous breathing-onset time, voluntary eye-opening time, and hemodynamic data were collected. Changes in the cerebral blood flow velocity in the middle cerebral artery were assessed using transcranial Doppler ultrasound. Results: In total, 164 patients completed the study. The extubation time was significantly shorter in the mild hypercapnia (13.9 ± 5.9 min, P = 0.024) than in the normocapnia group (16.3 ± 7.6 min). A similar reduction was observed in spontaneous breathing-onset time (P = 0.021) and voluntary eye-opening time (P = 0.008). Multiple linear regression analysis revealed that the adjusted ETCO2 level was a negative predictor of extubation time. Middle cerebral artery blood flow velocity was significantly increased after ETCO2 adjustment for mild hypercapnia, which rapidly returned to baseline, without any adverse reactions, within 20 min after extubation. Conclusions Mild hypercapnia during the recovery period significantly reduces the extubation time after TIVA. Increased ETCO2 levels can potentially enhance rapid recovery from IV anesthesia.

Background: Intraoperative hypercapnia reduces the time to emergence from volatile anesthetics, but few clinical studies have explored the effect of hypercapnia on the emergence time from intravenous (IV) anesthesia. We investigated the effect of inducing mild hypercapnia during the recovery period on the emergence time after total IV anesthesia (TIVA). Methods: Adult patients undergoing transurethral lithotripsy under TIVA were randomly allocated to normocapnia group (end-tidal carbon dioxide [ETCO2] 35–40 mmHg) or mild hypercapnia group (ETCO2 50-55 mmHg) during the recovery period. The primary outcome was the extubation time. The spontaneous breathing-onset time, voluntary eye-opening time, and hemodynamic data were collected. Changes in the cerebral blood flow velocity in the middle cerebral artery were assessed using transcranial Doppler ultrasound. Results: In total, 164 patients completed the study. The extubation time was significantly shorter in the mild hypercapnia (13.9 ± 5.9 min, P = 0.024) than in the normocapnia group (16.3 ± 7.6 min). A similar reduction was observed in spontaneous breathing-onset time (P = 0.021) and voluntary eye-opening time (P = 0.008). Multiple linear regression analysis revealed that the adjusted ETCO2 level was a negative predictor of extubation time. Middle cerebral artery blood flow velocity was significantly increased after ETCO2 adjustment for mild hypercapnia, which rapidly returned to baseline, without any adverse reactions, within 20 min after extubation. Conclusions Mild hypercapnia during the recovery period significantly reduces the extubation time after TIVA. Increased ETCO2 levels can potentially enhance rapid recovery from IV anesthesia.

Background: Intraoperative hypercapnia reduces the time to emergence from volatile anesthetics, but few clinical studies have explored the effect of hypercapnia on the emergence time from intravenous (IV) anesthesia. We investigated the effect of inducing mild hypercapnia during the recovery period on the emergence time after total IV anesthesia (TIVA). Methods: Adult patients undergoing transurethral lithotripsy under TIVA were randomly allocated to normocapnia group (end-tidal carbon dioxide [ETCO2] 35–40 mmHg) or mild hypercapnia group (ETCO2 50-55 mmHg) during the recovery period. The primary outcome was the extubation time. The spontaneous breathing-onset time, voluntary eye-opening time, and hemodynamic data were collected. Changes in the cerebral blood flow velocity in the middle cerebral artery were assessed using transcranial Doppler ultrasound. Results: In total, 164 patients completed the study. The extubation time was significantly shorter in the mild hypercapnia (13.9 ± 5.9 min, P = 0.024) than in the normocapnia group (16.3 ± 7.6 min). A similar reduction was observed in spontaneous breathing-onset time (P = 0.021) and voluntary eye-opening time (P = 0.008). Multiple linear regression analysis revealed that the adjusted ETCO2 level was a negative predictor of extubation time. Middle cerebral artery blood flow velocity was significantly increased after ETCO2 adjustment for mild hypercapnia, which rapidly returned to baseline, without any adverse reactions, within 20 min after extubation. Conclusions Mild hypercapnia during the recovery period significantly reduces the extubation time after TIVA. Increased ETCO2 levels can potentially enhance rapid recovery from IV anesthesia.

Background: Intraoperative hypercapnia reduces the time to emergence from volatile anesthetics, but few clinical studies have explored the effect of hypercapnia on the emergence time from intravenous (IV) anesthesia. We investigated the effect of inducing mild hypercapnia during the recovery period on the emergence time after total IV anesthesia (TIVA). Methods: Adult patients undergoing transurethral lithotripsy under TIVA were randomly allocated to normocapnia group (end-tidal carbon dioxide [ETCO2] 35–40 mmHg) or mild hypercapnia group (ETCO2 50-55 mmHg) during the recovery period. The primary outcome was the extubation time. The spontaneous breathing-onset time, voluntary eye-opening time, and hemodynamic data were collected. Changes in the cerebral blood flow velocity in the middle cerebral artery were assessed using transcranial Doppler ultrasound. Results: In total, 164 patients completed the study. The extubation time was significantly shorter in the mild hypercapnia (13.9 ± 5.9 min, P = 0.024) than in the normocapnia group (16.3 ± 7.6 min). A similar reduction was observed in spontaneous breathing-onset time (P = 0.021) and voluntary eye-opening time (P = 0.008). Multiple linear regression analysis revealed that the adjusted ETCO2 level was a negative predictor of extubation time. Middle cerebral artery blood flow velocity was significantly increased after ETCO2 adjustment for mild hypercapnia, which rapidly returned to baseline, without any adverse reactions, within 20 min after extubation. Conclusions Mild hypercapnia during the recovery period significantly reduces the extubation time after TIVA. Increased ETCO2 levels can potentially enhance rapid recovery from IV anesthesia.

Chronic bronchitis （CB） is a common respiratory system disease that is classified as a lung disease in traditional Chinese medicine （TCM） and is closely related to lung dysfunction. Lung Yang is the Yang Qi of the lungs，which drives the physiological activities within the lungs. It has physiological functions such as warming the lung system，regulating lung fluid，and dispersing the protective Yang. It can be distributed on the surface of the airway's Yin skin through sweat pores in the form of airflow and fluid，playing a protective and nourishing role. If the protective Yang fails to guard the Yin skin or if the lung fluid cannot nourish the Yin skin，the structural integrity of the airway's Yin skin may be compromised. This may weaken lung Yang's functions， such as clearing phlegm turbidity，dispersing lung fluid，and resisting external pathogens. Consequently， the retention of phlegm turbidity，insufficient nourishment of the Yin skin，and invasion by external pathogens all damage the lung Yang，burn the lung fluid，and exacerbate the pathological state of Yin skin unprotected，forming a vicious cycle that ultimately results in lung Yang asthenia and then the onset of CB. Based on the intrinsic connection between "Yin skin unprotected" and "lung Yang asthenia"，this paper interprets the etiology and pathogenesis of CB. It proposes that "Yin skin unprotected" in the airway is the basic cause of CB and "lung Yang asthenia" caused by "Yin skin unprotected" is the core pathogenesis of CB. By integrating micro differentiation indicators with macro differentiation syndromes， the study explores its modern biological basis. Guided by the theory of "warming the lung Yang and protecting the Yin skin" and based on modern pharmacology research，this study further explores the scientific connotation of single TCM and compound formulations for treating TCM by warming the lung Yang and protecting the Yin skin. Furthermore， it proposes methods for dispelling pathogenic factors and protecting the Yin skin during the acute exacerbation phase，as well as nourishing and warming lung Yang during the remission phase，in order to provide new ideas for the early prevention and treatment of TCM.

Objective:To explore the expression of miR-6883-5p in the serum of bladder cancer patients and its effect on the migration and proliferation ability of bladder cancer cells.Methods:The real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) method was used to detect the expression level of miR-6883-5p in the serum of 39 patients with bladder cancer and 39 healthy subjects, as well as the expression level of miR-6883-5p in normal bladder mucosal epithelial cells and bladder cancer cells. The bladder cancer cells with the lowest expression of miR-6883-5p were transfected with miR-6883-5p mimics or negative control (NC), namely miR-6883-5p group and NC group. Transwell migration experiment and cell counting kit-8 (CCK-8) colorimetric method were used to detect the migration and proliferation ability of cells transfected with miR-6883-5p. Bioinformatics software and dual luciferase reporter gene were used to predict and test the target genes of miR-6883-5p. qRT-PCR and Western blot were used to detect the expression levels of target genes in cells transfected with miR-6883-5p.Results:The expression level of miR-6883-5p in the serum of bladder cancer patients was significantly lower than that of healthy persons ( P<0.01). The expression level of miR-6883-5p in bladder cancer cells was significantly lower than that in normal bladder mucosal epithelial cells (all P<0.05), and the lowest expression of miR-6883-5p was in 5637 cells ( P<0.01). After transfection with miR-6883-5p, the migration and proliferation of cells in miR-6883-5p group were significantly lower than those in NC group (all P<0.05). Phosphatidyl alcohol proteoglycan-6 (GPC6) was the target gene of miR-6883-5p. After transfection with miR-6883-5p, the expression levels of GPC6 mRNA and protein in miR-6883-5p group significantly decreased ( P<0.01). Conclusions:miR-6883-5p is significantly low expressed in the serum of bladder cancer patients, and miR-6883-5p is related to the occurrence and development of bladder cancer; overexpression of miR-6883-5p can inhibit the migration and proliferation of bladder cancer cells; miR-6883-5p can inhibit the occurrence and development of bladder cancer by down-regulating the expression of GPC6.

Objective:To explore the clinical features and possible pathogenesis of spontaneous remission of acute myeloid leukemia (AML) .Methods:We retrospectively analyzed the clinical data of a patient with spontaneous remission of AML, MLL-AF9 rearrangement, and abnormal liver function in the First Affiliated Hospital of Zhengzhou University, and the relevant pieces of literature were summarized.Results:The patient experienced lung infection, fever, and liver dysfunction and was treated with anti-infection and blood transfusion. After complete response (CR) , the patient remained in CR with mild, indirect bilirubin elevation at 35 months of follow-up. Additionally, 56 cases of adult AML (non-acute promyelocytic leukemia) were reported in the literature from 1990 to June 2021. The cases were checked by bone marrow aspiration, and our patients were summarized and analyzed. Furthermore, 57 patients, including 37 males and 20 females, with a median age of 51 (20-83) years and a median remission time of five months; 52 patients achieved complete remission. In addition, there were five cases with long-term remission and a chromosomal record, with no recurrence so far, three with normal karyotype and two with t (9;11) (q21;q23) .Conclusion:The spontaneous remission of leukemia is rare and may be related to immunosuppression and genes.

OBJECTIVES: To evaluate the application value of CT-based radiomics features for the ascending and descending types of nasopharyngeal carcinoma (NPC). METHODS: A total of 217 NPC patients (48 ascending type and 169 descending type), who obtained CT images before radiotherapy in Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University from February 2015 to October 2017, were analyzed retrospectively. All patients were randomly divided into a training set (=153) and a test set (=64). Gross tumor volume in the nasopharynx (GTVnx) was selected as regions of interest (ROI) and was analyzed by radiomics. A total of 1 300 radiomics features were extracted via IBEX. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to choose the significant features. Support vector machine (SVM) and random forest (RF) classifiers were built and verified. RESULTS: Six features were selected by the LASSO from 1 300 radiomics features. Compared with SVM classifier, RF classifier showed better classification performance. The area under curve (AUC) of the receiver operating characteristic (ROC) curve, accuracy, sensitivity, and specificity were 0.989, 0.941, 1.000, and 0.924, respectively for the training set; 0.994, 0.937, 1.000, and 0.924, respectively for the validation set. CONCLUSIONS CT-based radiomics features possess great potential in differentiating ascending and descending NPC. It provides a certain basis for accurate medical treatment of NPC, and may affect the treatment strategy of NPC in the future.
Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity

Objective: Apolipoprotein E (ApoE) is mainly synthesized in the liver. So far, it is unknown the relationship among APOE gene polymorphisms and WML, brain atrophy. Therefore, the aim of the study was to assess the associations of APOE gene polymorphisms in patients with WML and brain atrophy. Methods: A total of 58 patients with WML, 128 patients with brain atrophy, 112 patients with co-occurrence of WML and brain atrophy and 95 healthy elderly volunteers were recruited from Renmin Hospital of WuHan University. Results: Allele E3 was the most common allele. The alleles E2 had significantly higher levels of ApoB and lower age in WML group. The alleles E2 was associated with the lower level of ApoB, LDL-Ch, TCh, and sdLDL in co-occurrence group. The E3/E3 genotype has higher level of sdLDL, but lower age and female frequency in WML. The E3/E4 genotype had higher level of TG, but lower age in WML. Gender, Age, E2, Hyperhomocysteinemia and UA were also significantly associated with disease progression. Conclusion This study found that clinical data, lipids and metabolic complications were closely related to ApoE genotypes and alleles, and also disease progression and type.

Objective: To explore the characteristics of the default memory network (DMN) and working memory network (WMN) at resting state brain functional network of exercise addiction people. Methods: Twenty-nine sports addicts and 26 non-sports addicts matched by sex, age, average education level and sports dependence were screened by the exercise addiction index (EAI). Resting status brain scanning was performed with 3.0T magnetic resonance scanner.Sparse approximation coefficients independent component analysis (SACICA) model was used to analyze the independent components of brain networks. Results: Compared with the DMN template, four features were extracted, including " basic conformity" , " less frontal lobe" , " more frontal lobe" and " less occipitoparietal lobe" . Compared with the parameters of " basic conformity" , the proportion of exercise addiction group (33.3%, 9/27) was higher than that of control group (18.2%, 4/22). In the other three parameters, the proportion of exercise addiction group (37.0%, 10/27; 3.7%, 1/27; 22.2%, 6/27) was lower than those of control group (45.5%, 10/22; 22.7%, 5/22; 27.3%, 6/22). But Chi-square test showed that there was no significant difference between the two groups(all P>0.05). Compared with the WMN template, six features were extracted, including " basic conformity" , " more frontal and parietal lobes" , " more parietal lobes" , " more frontal lobes" , " less frontal lobes" and " less parietal lobes" . The percentages of the first three features in exercise addiction group (22.2%, 6/27; 7.4%, 2/27; 7.4%, 2/27) were less than those in the control group (45.5%, 10/22; 22.7%, 5/22; 9.1%, 2/22), while the percentages of the last three features in the exercise addiction group (7.4%, 2/27; 37.0%, 10/27; 14.8%, 4/27) were higher than those in the control group (4.5%, 1/22; 13.6%, 3/22; 0, 0). Chi-square test showed that there was no significant difference in all features between the two groups was statistically(P>0.05). Conclusion No significant characteristic changes are found in DMN and WMN networks of exercise addiction population.