Objective To observe the effects of intravenous or inhalation anesthesia on perioperative re-spiratory system adverse events(PRAE)in children after extubation.Methods A total of 100 children pa-tients with elective tonsillectomy or adenoidectomy under general anesthesia endotracheal intubation in this hospital from July to December 2023 were selected as the study subjects and divided into the intravenous anes-thesia group and inhalation anesthesia group according to the random number table method,50 cases in each group.The intravenous anesthesia group used propofol for venous induction and maintenance,while the inha-lation anesthesia group used sevoflurane inhalation for induction and maintenance.The incidence rate of PRAE after extubation,anesthetic maintenance stage quality,incidence rates of postoperative nausea,vomiting and agitation were recorded in both groups.Results Compared with the inspiration anesthesia group,the PRAE incidence rate(16.0％vs.42.0％),hypoxia incidence rate(14.0％vs.38.0％)and pediatric anaesthesia e-mergence delirium(PAED)score[5(2,8)points vs.6(4,11)points]in the venous anesthesia group were low-er,the extubation time was longer[(19.6±10.6)min vs.(14.9±8.9)min],postanesthesia care unit(PACU)stay time was shorter[(25.4±5.2)min vs.(27.9±6.4)min],the differences were statistically significant(P＜0.05).The proportions of intubation time,intubation times＞once and the swallow and limb activity dur-ing anesthetic maintenance had no statistical difference between the two groups(P＞0.05).The heart rate had no statistical difference among 4 time points of before and after induction,after intubation and after extu-bation(P＞0.05).Compared with before induction,the heart rate after extubation was significantly increased,and the difference was statistically significant(P＜0.05).Conclusion The incidence rate of PARE in pediatric ve-nous anesthesia is lower.

Objective To use superparamagnetic iron oxide nanoparticles(SPIONs)to label chimeric antigen receptor(CAR)T cells targeting carcinoembryonic antigen(CEA),and perform magnetic resonance imaging(MRI)to real time trace CEA CAR-T cells in vivo.Methods Appropriate amount of ferumoxytol,heparin sodium and protamine sulfate were mixed at high(ferumoxytol 100 μg/mL,heparin sodium 4 IU/mL,protamine sulfate 120 μg/mL),medium(ferumoxytol 50 μg/mL,heparin sodium 2 IU/mL,protamine sulfate 60 μg/mL),and low(ferumoxytol 25 μg/mL,heparin sodium 1 IU/mL,protamine sulfate 30 μg/mL)concentrations to form a SPIONs complex ferumoxytol/heparin/protamine(FHP),and then co-incubated with CEA CAR-T cells for cell labeling.The biocompatibility of FHP was detected by CCK-8 assay,EdU assay and flow cytometry.The uptake of FHP was detected by Prussian blue staining,and SPIONs content in the cells was quantitatively detected by inductively coupled plasma-mass spectrometry(ICP-MS).Flow cytometry was used to detect the lytic effect of FHP-labeled CEA CAR-T cells on tumor cells,and MRI was employed to scan FHP-labeled CEA CAR-T cells.Results FHP at high,medium,and low concentrations had no significant effect on the activity of CEA CAR-T cells,with cell activity above 100％determined by CCK-8 assay.DNA proliferation was above 94.3％in EdU assays.Prussian blue staining showed that CEA CAR-T cells could take FHP up,with the uptake increased with the increment of FHP concentration.ICP-MS showed that the intracellular Fe content was 440.23±189.36 ng/mL.Tumor cell killing experiment showed that FHP-labeled CEA CAR-T cells had excellent killing capability against tumor cells.MRI scans indicated that T2WI signals of FHP-labeled CEA CAR-T cells were significantly reduced with increasing FHP concentration(P＜0.01).Conclusion SPIONs complex FHP shows good biocompatibility and can effectively label CEA CAR-T cells.SPIONs complex FHP can be used as a magnetic marker for CEA CAR-T cells and a feasible MRI tracer for clinical application.

Clinical cases treated by magnetic compression anastomosis (MCA) for different causes and types of intestinal stenosis/ atresia to successfully achieve intestinal recanalization were reviewed, so as to explore the clinical application of MCA. From May 2019 to August 2022, 4 patients underwent colorectal MCA for intestinal recanalization in the First Affiliated Hospital of Xi'an Jiaotong University and Northwest Women and Children's Hospital. All operations went well, and the intestinal anastomosis was recanalized. The magnetic ring was discharged in 7-15 days, and the postoperative colonoscopy or radiography showed that the anastomosis was intact. MCA can be used to treat different types of colorectal stenosis and atresia due to different reasons, and can also be used to assist intestinal anastomosis in colorectal surgery.

Objective:To investigate the risk factors of cardiovascular and cerebrovascular diseases in young patients with hyperhomocysteinemia.Methods:A total of 260 patients younger than 45 years old who received treatment at the Department of Emergency, Seventh Medical Center, Chinese PLA General Hospital from January 2018 to January 2019 were included in this study. Among these patients, 126 patients with serum homocysteine levels ≥ 15.0 μmol/L were included in the hyperhomocysteinemia group, and 134 patients with serum homocysteine levels < 15.0 μmol/L were included in the control group. Height, body weight, body mass index, blood pressure, homocysteine, fasting blood glucose, blood uric acid, total cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and N-terminal B-type natriuretic peptide were determined in each group. Changes in risk factors of cardiovascular and cerebrovascular diseases were compared between the hyperhomocysteinemia and control groups.Results:There were significant differences in body mass index [(26.42 ± 3.54) kg/m 2vs. (22.14 ± 3.22) kg/m 2, t = 10.21, P = 0.016], blood uric acid [(308.71 ± 78.44) μmol/L vs. (285.05 ± 92.09) μmol/L, t = 2.22, P = 0.027], the incidence of coronary heart disease (73/126 vs. 61/134, χ2 = 4.00, P = 0.045) and the incidence of stroke (19/126 vs. 6/134, χ2 = 8.39, P = 0.004) between the hyperhomocysteinemia and control groups. There were no significant differences in fasting blood glucose, blood lipid level, N-terminal B-type natriuretic peptide, and the incidences of diabetes mellitus and hypertension between the two groups (all P > 0.05). Conclusion:The related risk factors of cardiovascular and cerebrovascular diseases increase in young patients with hyperhomocysteinemia. The incidences of coronary heart disease and stroke are very high, and therefore timely intervention should be carried out.

【Objective】 To investigate the effects of hsa_circ_0045943 targeting miR-106a on the biological characteristics of gastric cancer cells and its mechanism. 【Methods】 Human gastric cancer cells MKN-45， AGS and gastric mucosal epithelial cells GES-1 were cultured； circ_0045943 was detected by real-time polymerase chain reaction. The overexpression and silencing of circ_0045943 adenovirus vectors OE-circRNA and sh-circRNA together with their negative controls OE-NC and sh-NC were constructed and transfected； CCK-8 method was used to detect the proliferation activity of AGS cells after overexpression and silencing of circ_0045943； TUNEL method was used to detect the cell apoptosis； transwell assay was used to detect the cell migration and invasion； and would healing assay was used to detect the cell migration. Starbase database screened the binding site of miR-106a and circ_0045943. Real-time PCR was used to detect the expression of miR-106a， and the expression of circ_0045943 and the changes of miR-106a after the treatment of OE-circRNA and sh-circRNA. 【Results】 Real-time PCR showed that the expression of circ_0045943 decreased in gastric cancer cells MKN-45 and AGS compared to GES-1 （Pboth<0.001）. CCK-8 showed that the absorbance value of AGS cells in OE-circRNA group was lower than that in sh-circRNA group （P24 h<0.01， P48 h<0.001， and P72 h<0.001）. TUNEL showed the number of apoptotic AGS cells increased after overexpression of circ_0045943， but decreased after silencing of circ_0045943. Transwell assay showed that the migration and invasion of AGS cells were lower in OE-circRNA group than in sh-circRNA group （Pboth<0.001）. The wound healing assay showed that the migration rate of AGS cells in OE-circRNA group was the lowest， but was high in sh-circRNA group （P<0.001）. Starbase retrieved that circ_0045943 and miR-106a had complementary binding sequences. Real-time PCR showed that miR-106a was highly expressed in gastric cancer cells （P<0.001）， and the expressions of circ_0045943 and miR-106a significantly differed after treatment with OE-circRNA and sh-circRNA （Pboth<0.001）. With the increase or decrease of circ_0045943， the expression of miR-106a changed in the opposite direction. 【Conclusion】 Circ_0045943 has low expression in gastric cancer， and promoting or inhibiting circ_0045943 expression may regulate the proliferation， apoptosis， migration and invasion of gastric cancer cells by targeting miR-106a.

【Objective】 To study the role and mechanism of sinomenine in the macrophage polarization induced by gastric cancer cells. 【Methods】 Sinomenine was added to gastric cancer cells BGC-823 and MKN-45， cell viability was measured by CCK-8， cell proliferation was measured by colony formation experiment， Co-culture and Transwell cell migration experiments were used to evaluate the recruitment and polarization of macrophages by sinomenine， flow cytometry was used to evaluate the polarization of macrophages， and qRT-PCR and Western blot were used to detect the expression of gene RNA and protein levels. 【Results】 Sinomenine could inhibit the proliferation of gastric cancer cells and the recruitment of gastric cancer cells to macrophages， thus promoting macrophage M2 polarization. It simultaneously inhibited the expression of STAT6 as well as the expression and phosphorylation of C/EBPβ. When STAT6 is overexpressed， it could reduce these inhibitory effects of sinomenine on gastric cancer cells. Further research found that STAT6 mediated the secretion of IL-6 by gastric cancer cells， which was the cause of sinomenine-mediated macrophage recruitment and M2 polarization. 【Conclusion】 The natural drug sinomenine has a good tumor-suppressing ability against gastric cancer， directly inhibits the survival and migration of gastric cancer cells， and inhibits the expression of IL-6 and the M2 phenotype in the tumor microenvironment， reshapes the tumor environment， and reduces the risk of M2 type macrophages for gastric cancer tumors.

【Objective】 To explore and evaluate infection control measures of preventing cross-contamination of novel coronavirus during gastrointestinal endoscopy treatment. 【Methods】 According to the hospital’s infection control requirements and related documents, infection control measures were formulated and implemented by combining with our actual clinical situation, including the management of the endoscope room, management and protection of patients and endoscopists. Then, we evaluated the effect of these measures. 【Results】 From January 25 to March 10, 2020, a total of 71 patients (53 males and 18 females) completed gastrointestinal endoscopy treatment, with an average age of 54 years (28-81 years). There were 36 (50.7%) cases of emergency treatment. All patients had been kept in quarantine for about 14 days (24±13), and no cross-contamination of novel coronavirus occurred. 【Conclusion】 During the novel coronavirus infection epidemic period, reasonable and effective measures should be taken to minimize the risk of infection in doctors and patients. The endoscope center should strengthen preoperative screening and management of patients, master indications of endoscopic procedures, complete endoscopists’ management and protection work, strictly follow the specifications of sterilizing gastrointestinal endoscopes, and construct the layout of "three zones and two passages".

Objective:To investigate the correlation between serum adiponectin (APN) and inflammatory markers, nutritional status and severe acute exacerbation in late stage in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:One hundred and sixty-three male patients with AECOPD from July 2017 to April 2019 in Wusong Hospital of Baoshan District, Shanghai City were selected. The patients were divided into low APN group (serum APN ≤ 102.38 μg/L, 97 cases) and high APN group (serum APN>102.38 μg/L, 66 cases). The interleukin (IL)-6, IL-8, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), hemoglobin, albumin, prealbumin, body mass index (BMI) and number of severe acute exacerbation in 1 year′ follow-up were compared between 2 groups, and the correlation between APN and inflammatory markers, nutritional status and number of severe acute exacerbation were analyzed.Results:The BMI, hemoglobin, prealbumin and albumin in low APN group were significantly higher than those in high APN group: (23.20 ± 3.26) kg/m 2 vs. (20.77 ± 3.78) kg/m 2, (133.23 ± 17.13) g/L vs. (125.68 ± 20.83) g/L, (185.36 ± 57.60) g/L vs. (148.83 ± 64.79) g/L, (37.09 ± 4.06) g/L vs. (33.77 ± 5.86) g/L, and there were statistical differences ( P<0.01 or<0.05); there were no statistical differences in total protein, IL-6, IL-8, CRP and ESR between 2 groups ( P>0.05). APN showed negative correlation with BMI, hemoglobin, albumin and prealbumin ( r = -0.42, -0.28, -0.33 and -0.31; P<0.01); there was no correlation with IL-6, IL-8, ESR and CRP ( P>0.05). The rate of 4 times of severe acute exacerbation in 1 year′ follow-up in low APN group was significantly lower than that in high APN group: 8.25% (8/97) vs. 22.73% (15/66), and there was statistical difference ( χ2 = 6.79, P<0.05). Conclusions:The AECOPD patients with low APN have better nutritional status and less exacerbation. Serum APN can be used as a predictive index of severe acute exacerbation in AECOPD patients

Objective To synthesize 18F-AlF-1,4,7-triazacyclononane-l,4,7-triacetic acid (NOTA)-c (CGRRAGGSC),which could specifically bind to the α chain of interleukin (IL)-11 receptor (IL-11 R),and evaluate its targeting potential to IL-11 R-positive tumors.Methods Polypeptide c (CGRRAGGSC) was first coupled with NOTA and then labeled with 18F by AlF labeling method.The radiochemical purity and radiochemical yield of 18F-AlF-NOTA-c(CGRRAGGSC) were analyzed by high performance liquid chromatography,and the stability in vitro was evaluated.The tracer biodistribution in tumor-bearing mice (cell line SKOV3) was evaluated by the dynamic imaging with microPET 30 min,1 h,2 h after injection of 18F-AlF-NOTA-c (CGRRAGGSC).The tracer kinetics was performed in normal mice.Pharmacokinetics parameters were calculated using DAS2.0 software.Results The radiochemical purity of 18F-AlF-NOTA-c(CGRRAGGSC) was higher than 95％ and the radiochemical yield was (30.0±7.4)％.It could be stably maintained in phosphatebuffered solution and plasma for at least 2 h.MicroPET imaging showed that 18F-AlF-NOTA-c(CGRRAGGSC)had a good affinity to SKOV3 tumor.The tumor/muscle ratios at 30 min,1 h,2 h after the injection of 18F-AlF-NOTA-c(CGRRAGGSC) were 6.26±2.98,7.19±3.63 and 9.05±4.30,respectively.The tracer was cleared rapidly in blood and mainly excreted by the liver and kidneys.The T1/2α and T1/2β were (0.38±0.14) h and (2.64±0.28) h,respectively.Conclusions 18F-AlF-NOTA-c(CGRRAGGSC) is easy to be synthesized and has a good affinity to IL-11R-positive tumors.It will be a potential IL-11R-targeting imaging agent.

Objective The protective effect of oleanolic acid on acute cholestatic liver injury in rats. Methods Thirty male SD rats were randomly divided into 3 groups ( n= 10 per group): sham group, bile duct ligated (BDL) group, and bile duct ligated with oleanolic acid (BDL+OA ) group. After 7 days, liver samples in all rats were collected. Expressions of bile acids pump and nuclear receptors at mRNA and protein levels were detected by RT- qPCR and Western blotting. Results At mRNA level, the expression of Mrp4 and Oatp1 expression in the BDL and BDL+OA groups were increased as compared with that in the sham group. The expression of Mrp4 increased 1.8 times in the BDL group and increased 2.3 times in the BDL+OA group (P<0.05), but the expression of Oatp1 was not statistically significant; AhR was increased 1.7-fold in the BDL group and 2.8 times in the BDL+OA group, Nrf2 was increased 1.5-fold in the BDL group and 2.1 times in the BDL+OA group with statistically significant difference. At the protein level, in the BDL group, Mrp4 expression increased 1.3 times, Oatp1 expression increased 1.5 times, AhR expression increased 1.3 times, Nrf2 expression increased 1.4 fold; in the BDL+OA group, Mrp4 expression increased 1.8 fold, AhR expression increased 1.9 fold, with statistical significance between the two groups. Oatp1 expression increased 1.4-fold in the BDL+OA group as compared with the BDL group showing no statistical significance. Conclusions Oleanolic acid stimulates the hepatic expression of bile acids pump Mrp4 associated with the activation of nuclear receptors AhR and Nrf2 in acute bile ductligated rats.