ObjectiveTo explore the impacts of material type and loading volume of rigid containers on the hydrogen peroxide low temperature plasma sterilization of thoracoscopic instruments, to identify the best rigid containers and loading volume of thoracoscopic instruments. MethodsThoracoscopic instruments sterilized by STERRAD^® 100NX hydrogen peroxide low temperature plasma in Shanghai Pulmonary Hospital affiliated to Tongji University from August to September 2024 were selected as the research items. According to the material of rigid containers, the instruments were divided into polyethylene case group (A), stainless steel case group (B) and silicone resin case group (C). In terms of the loading volume, the rigid containers were divided into (loading capacity <80%) groups of 8, 10 and 12 instruments. The results of physical monitoring, the first type of chemical indicator card monitoring, and the five types of card luminal chemical process challenge device (PCD) monitoring of the 9 groups of A8, A10, A12, B8, B10, B12, C8, C10 and C12 were compared and evaluated. ResultsCompared to A8, A10 A12, C8, C10 or C12 groups, the thoracoscope instruments in the stainless steel containers in B8, B10 or B12 group had higher hydrogen peroxide concentrations and shorter elapsed time in the pressure check phases 1 and phases 2, with the differences statistically significant (P<0.05), followed by the silicone resin case group and the polyethylene case group. The nine groups of physical parameter monitoring, the first type of chemical indicator monitoring, and the five types of chemical PCD monitoring for lumen sterilization achieved 100% qualification rates, and there were no significant differences in the qualified rates of sterilization among the 9 groups (P>0.05). ConclusionWhen using hydrogen peroxide low temperature plasma to sterilize thoracoscopic instruments, it is recommended to use stainless steel or silicone resin rigid containers with a controlled loading capacity (≤12) to ensure optimal sterilization quality.

Objective This study was to explore factors related to early radial artery occlusion(RAO)associated transradial approach(TRA).Methods Patients who underwent the TRA from July 2021 to Jan 2024 were included in our study.Patients were divided into radial artery occlusion group and non-radial artery occlusion group.The data of general demography,the number of radial artery punctures attempts,and whether add heparin to the Antispasmodic Agents were recorded to assess the incidence and predictors of RAO.Results A total of 543 patients were included in the study.All patients underwent ultrasound evaluation 24h after DSA.Among them,32 cases experienced RAO,while 511 cases did not experienced RAO.The occurrence rate of RAO was significantly higher in patients without addition of heparin to the antispasmodic agents for the prevention of radial artery spasm,those with more than 3 radial artery puncture attempts and those using either an 11 cm short sheath,or Cordis puncture needles(all P<0.05).Multiple logistic analysis showed that addition of heparin to the Antispasmodic Agents(OR=0.076,95% CI:0.018～0.321,P<0.001),less than 3 radial artery puncture attempts(OR=0.245,95% CI:0.111～0.541,P<0.001),using an 16 cm longer sheath(OR=0.195,95% CI:0.067～0.564,P=0.003),using an Terumo puncture needles(OR=0.325,95% CI:0.148～0.717,P=0.005)could reduce the incidence of RAO.Conclusions Anticoagulation with intrathecal heparin,application of trocar to improve the success rate of puncture,and the use of a 16 cm long sheath can significantly reduce the incidence of early RAO after DSA.

Objective:To investigate the establishment and application value of a radio-mics prediction model for lymph node metastasis of gallbladder carcinoma based on dual-phase enhanced computed tomography (CT).Methods:The retrospective cohort study was conducted. The clinicopathological data of 194 patients with gallbladder carcinoma who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2012 to December 2020 were collected. There were 70 males and 124 females, aged (64±10)years. All patients underwent curative-intent resection of gallbladder carcinoma. A total of 194 patients were randomly divided into 156 cases in training set and 38 cases in test set according to the ratio of 8:2 based on random number method in R software. The training set was used to establish a diagnostic model, and the test set was used to validate the diagnostic model. After the patients undergoing CT examination, image analysis was performed, radiomics features were extracted, and a radiomics model was established. Based on clinicopathological data, a nomogram prediction model was established. Observation indicators: (1) lymph node dissection and histopathological examination results; (2) establishment and characteristic analysis of a radiomics prediction model; (3) analysis of influencing factors for lymph node metastasis of gallbladder carcinoma; (4) establishment of a nomogram prediction model for lymph node metastasis; (5) comparison of the predictive ability between the radiomics prediction model and nomogram prediction model for lymph node metastasis. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were expressed as absolute numbers, and comparison between groups was performed by the chi-square test. Univariate analysis was conducted by the chi-square test, and multivariate analysis was performed by the Logistic regression model forward method. The receiver operating characteristic curve was drawn, and the area under curve, decision curve, confusion matrix were used to evaluate the predictive ability of prediction models. Results:(1) Lymph node dissection and histopathological examination results. Of the 194 patients, 182 cases underwent lymph node dissection, with the number of lymph node dissected as 8(range, 1?34) per person and the number of positive lymph node as 0(range, 0?11) per person. Postoperative histopathological examination results of 194 patients: 122 patients were in stage N0, with the number of lymph node dissected as 7(range, 0?27) per person, 48 patients were in stage N1, with the number of lymph node dissected as 8(range, 2?34) per person and the number of positive lymph node as 1(range, 1?3) per person, 24 patients were in stage N2, with the number of lymph node dissected as 11(range, 2?20) per person and the number of positive lymph node as 5(range, 4?11) per person. (2) Establishment and characteristic analysis of a radiomics prediction model. There were 107 radiomics features extracted from 194 patients, including 18 first-order features, 14 shape features and 75 texture features. According to the intra-group correlation coefficient and absolute median difference of each radiomics feature, mutual information, Select K-Best, least absolute shrinkage and selection operator regression were conducted to further reduce dimensionality. By further combining 5 different machine learning algorithms including random forest, gradient boosting secession tree, support vector machine (SVM), K-Nearest Neighbors and Logistic regression, the result showed that the Select K-Best_SVM model had the best predictive performance after analysis, with the area under receiver operating characteristic curve as 0.76 in the test set. (3) Analysis of influencing factors for lymph node metastasis of gallbladder carcinoma. Results of univariate analysis showed that systemic inflammation response index, carcinoembryonic antigen (CEA), CA19-9, CA125, radiological T staging and radiological lymph node status were related factors for lymph node metastasis of patients with gallbladder cancer ( χ2=4.20, 11.39, 5.68, 11.79, 10.83, 18.58, P<0.05). Results of multivariate analysis showed that carcinoembryonic antigen, CA125, radiological T staging (stage T3 versus stage T1?2, stage T4 versus stage T1?2), radiological lymph node status were independent influencing factors for lymph node metastasis of patients with gallbladder carcinoma [ hazard ratio=2.79, 4.41, 5.62, 5.84, 3.99, 95% confidence interval ( CI) as 1.20?6.47, 1.81?10.74, 1.50?21.01, 1.02?33.31, 1.87?8.55, P<0.05]. (4) Establishment of a nomogram prediction model for lymph node metastasis. A nomogram prediction model was established based on the 4 independent influencing factors for lymph node metastasis of gallbladder carcinoma, including CEA, CA125, radiological T staging and radiological lymph node status. The concordance index of the nomogram model was 0.77 (95% CI as 0.75?0.79) in the training set and 0.73 (95% CI as 0.68?0.72) in the test set, respectively. (5) Comparison of the predictive ability between the radiomics predic-tion model and nomogram prediction model for lymph node metastasis. The receiver operating characteristic curve showed that the areas under the curve of Select K-Best_SVM radiomics model were 0.75 (95% CI as 0.74?0.76) in the training set and 0.76 (95% CI as 0.75?0.78) in the test set, respectively. The areas under the curve of nomogram prediction model were 0.77 (95% CI as 0.76?0.78) in the training set and 0.70 (95% CI as 0.68?0.72) in the test set, respectively. The decision curve analysis showed that Select K-Best_SVM radiomics model and nomogram prediction model had a similar ability to predict lymph node metastasis. The confusion matrix showed that Select K-Best_SVM radiomics model had the sensitivity as 64.29% and 75.00%, the specificity as 73.00% and 59.09% in the training set and test set, respectively. The nomogram had the sensitivity as 51.79% and 50.00%, the specificity as 80.00% and 72.27% in the training set and test set, respectively. Conclusion:A dual-phase enhanced CT imaging radiomics prediction model for lymph node metastasis of gallbladder carcinoma is successfully established, and its predictive ability is good and consistent with that of nomogram.

Objective: To understand the prevalence of sexual abuse among rural children and its association with family cohesion and adaptability, and to explore factors that may affect household functions of the victims. Methods: A total of 1 666 rural middle school students in Hanchuan and Yunxi, Hubei were recruited with stratified cluster sampling method, multivariate Logistic regression was used to analyze associated factors of the household functions of the victims. Results: A total of 175 (10.50%) reported non-contact sexual abuse and 44 (2.64%) reported contact sexual abuse. Compared with control group, sexual abuse victims reported lower scores of family cohesion (F=8.97，P<0.01) and adaptability (F=4.09，P=0.02). Among the victims, maternal absence was a risk factor for poor family cohesion(OR=0.20，P<0.01), higher parental educational level and appropriate parenting methods(P<0.05) were protective factors for family cohesion and family adaptability. Conclusion Household functions of children sexual abuse victims in rural areas are generally poor, especially for victims with mothers absence, low parental education and improper parenting style. More attention should be paid to such children to minimize the impact of negative events such as sexual abuse.

Objective: To investigate the picky eating behavior among school-age children and to analyze its association with their health status, providing scientific basis for health promotion of school-age children in China. Methods: A total of 796 students of grade 3 to grade 6 from two primary schools in Hongshan, Wuhan were selected through cluster sampling. Statistical analysis was conducted according to the results of the 3-day food record and questionnaire survey on children and their caregivers. Results: In the current study, 40.58% of the children had picky eating problems, the incidence of picky eating behaviors of migrant children was higher than that of local children(χ2=3.92, P<0.05). Most of the picky eaters(23.87%) tended to reject vegetables. Compared to the others, picky eaters had lower intake of vitamin B 2 [(0.49±0.01)(0.46±0.01)mg] and vitamin C [(57.35±0.76)(54.32±0.90)mg] (t=2.03, 2.57, P<0.05) and had a higher risk of stunting(OR=1.42, P<0.05). Conclusion Picky eating behaviors are common among school-age children, which is significantly associated with stunting. Nutritional education for children (especially migrant children) are urgently needed to improve their dietary structure and promote healthy growth and development.

Objective: To analyze the relationship between single nucleotide polymorphisms (SNP) of Notch signaling pathway and susceptibility to lung cancer. Methods: The present study was a hospital-based case-control study. All 1 121 patients of lung cancer diagnosed by histopathology three hospitals in Fujian and Nanjing were selected as cases from January 2006 to December 2012. At the same time, 1 121 healthy population from other departments of the hospital to visit patients or community, excluding those with tumor, chronic disease, and immediate family members of lung cancer, were enrolled in control group. A uniform questionnaire was used to collect general information. Matrix-assisted laster desorption ionization time of flight mass spectrometry (MALDI-TOF-MS) was used to identify the polymorphisms of 9 SNP (Notch3 rs3815188, Notch4 rs915894, Notch4 rs520692, DLL1 rs1033583, JAG1 rs8708, JAG2 rs9972231, HEY1 rs1046472, HEY2 rs3734637, HES2 rs11364) in 1 121 lung cancer patients and 1 121 healthy controls. The association between SNP and lung cancer was analyzed by χ² and logistic regression model. Results: The average age of cases and controls was (58.70±10.73) and (58.98±10.85) years old. The OR for genotype AC carriers of HEY1 rs1046472 was 0.80 (95%CI: 0.66-0.97) when comparing with genotype CC. The OR for genotype AC+AA carriers of HEY1 rs1046472 was 0.81 (95% CI: 0.67-0.98) when comparing with genotype CC. The OR for genotype AC carriers of HEY2 rs3734637 was 0.82 (95%CI: 0.67-0.99) when comparing with genotype AA. In the stratified analysis, Notch3 rs3815188, DLL1 rs1033583, JAG1 rs8708, JAG2 rs9972231, HEY1 rs1046472, HEY2 rs3734637, HES2 rs11364 were associatied with the risk of lung cancer, P were 0.041, 0.030, 0.043, 0.003, 0.004, 0.026 and 0.038, respectively.The interactions analysis done by logistic regression model showed JAG1 rs8708 and family history, JAG2 rs9972231 and BMI had interaction in the study, OR were 2.07 (95% CI:1.21-3.52) and 1.73 (95% CI:1.21-2.47), respectively. Conclusion Notch3 rs3815188, DLL1 rs1033583, JAG1 rs8708, JAG2 rs9972231, HEY1 rs1046472, HEY2 rs3734637 and HES2 rs11364 were significantly associated with susceptibility to lung cancer.

OBJECTIVE:To investigate the effects of Shenfukang capsules on clinical efficacy and renal function indexes of patients with renal insufficiency. METHODS:Totally 100 inpatients with renal insufficiency treated by Shenfukang cap-sules in the First Affiliated Hospital of Guangxi Medical University during Feb. to Mar. 2015 were analyzed retrospectively in respects of general information of patients,therapy plan,renal function indexs before and after treatment and clinical effica-cy. The relationship of clinical efficacy with age and duration was also analyzed. RESULTS:There were 33 cases of acute re-nal insufficiency and 67 cases of chronic renal insufficiency. The route of administration of Shenfukang capsules was oral ad-ministration(97 cases,97.00%),the main dosage was 6 capsule/d(36 cases,36.00%),and treatment duration were 0-<7 days(39 cases)and 7-<15 days(49 cases). After treatment,the average serum creatinine concentration was lower than be-fore treatment,while mean GFR and Ccr were higher than before treatment,with statistical significance(P<0.05). The total response rate was 72.00%,and response rate of patients with acute renal insufficiency was 87.88% and significantly higher than 64.18% of patients with chronic renal insufficiency,with statistical significance(P<0.05). Among patients with ≤60 years old,the total response rate of patients with acute renal insufficiency was significantly higher than that of patients with chronic renal insufficiency,with statistical significance(P<0.05);among patients elder than 60 years old,there was no statistical significance in therapeutic efficacy between acute renal insufficiency and chronic renal insufficiency(P>0.05);among patients with chronic renal insufficiency,the total response rate of patients elder than 60 years old was significantly better than that of patients with ≤60 years old,with statistical significance (P<0.05). With the extension of treatment duration,the total response rate of patients with acute renal insufficiency was on the rise,and that of patients with chron-ic renal insufficiency increased first and then decreased. No obvious ADR was found during treatment. CONCLUSIONS:Shenfu-kang capsules can improve renal function in patients with renal insufficiency,and has definite curative effect on acute and chronic renal insufficiency with good security. The clinical efficacy may be related to age and treatment course.

Objective To analyze the effect of gender on the prognosis of patients with non-small cell lung cancer (NSCLC).Methods Data of 1 195 patients with NSCLC were analyzed by Chi-square,Kaplan-Meier,log-rank tests and Cox regression models.Results Women had a longer survival than men (median overall survival 31.64 versus 22.71 months,P＜0.01) in the participants of this study.Differences seen in overall survival remained the similar,after stratified by age,pathologic types,clinical stage,sizes,pleural effusion and surgery of the patients,respectively.Data from the multivariate analysis revealed that factors as smoking,clinical stage,metastatic when diagnosis was made and surgery,but not gender,were independent prognostic factors for patients with NSCLC.After adjustment for potential confounders,we found that smoking was a major confounding factor,affecting the relationship between gender and prognosis of NSCLC.Conclusion Gender did not seem an independent prognostic factor for NSCLC patients while the survival advantages of females might be attributed to the lower prevalence of smoking in this population.

Objective To investigate the antitumor effects and the possible mechanisms of dendrit-ic cells co-cultured with cytokine-induced killer cells(DC-CIK)in combination with sorafenib on two lung adenocarcinoma cell lines,A549 cells(harboring KRAS gene mutation)and PC-9 cells(harboring EGFR gene mutation). Methods DC and CIK cells were routinely generated in vitro by stimulating PBMCs isola-ted from lung cancer patients with different cytokines and then co-cultured after a week of culturing. Flow cy-tometry analysis(FCM)was used to analyze the phenotype of DC-CIK cells after 7 days of co-culturing. The 50% inhibitory concentration(IC50 )of sorafenib against tumor cells was detected by MTT assay. The tumor cells were treated with DC-CIK cells alone or in combination with sorafenib. The proliferation of tumor cells was tested by CCK-8 kit and dynamically monitored by real-time cellular analysis(RTCA). Annexin-V/ PI staining was used to examine the apoptosis rates in each group. Real-time fluorescent quantitative PCR and FCM were respectively performed to detect the expression of natural killer group 2 member D ligands (NKG2DLs)at mRNA and protein levels after the treatment with sorafenib for 24 h. Results There was no significant difference between the IC50 of sorafenib against A549 and PC-9 cells after a 24-hour exposure(P﹥0. 05). Compared with the DC-CIK biotherapy,treating the tumor cells with DC-CIK cells in combination with sorafenib significantly inhibited the cell proliferation and increased the total apoptosis rates of tumor cells(P﹤0. 05). Moreover,the inhibition rates to tumor cell proliferation were enhanced along with the in-crease of effect-to-target ratio(E/ T). Compared with the single-factor treatment groups,the normalized cell index(NCI)in the combined treatment group was significantly decreased. Blocking NKG2D could abate the inhibitory effect of DC-CIK cells on tumor cell proliferation(P﹤0. 05). The expression of NKG2DLs(inclu-ding ULBP1,UBLP2 and ULBP3)on tumor cells at mRNA and protein levels were increased to different ex-tent after treating with 5 μmol/ L of sorafenib for 24 h. Conclusion There was no significant different be-tween the inhibitory effects of sorafenib on the proliferation of lung adenocarcinoma cancer cells harboring KRAS or EGFR gene mutation. The antitumor effects of DC-CIK cells combined with sorafenib on lung ade-nocarcinoma cells might be induced by regulating the NKG2D-NKG2DLs pathway and enhancing apoptosis. Moreover,the antitumor effects of the combined treatment were better than those of single-factor treatments.

Objective To compare the pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) in the patients undergoing spinal surgery in prone position supported by a Wilson frame.Methods Forty patients,of ASA physical status Ⅰ or Ⅱ,aged 30-64 yr,with body mass index ＜ 30 kg/m2,scheduled for elective spinal surgery in prone position supported by a Wilson frame under general anesthesia,were randomly allocated to receive mechanical ventilation using either VCV (n =20) or PCV (n =20) mode.Endotracheal intubation and mechanical ventilation were performed after induction of anesthesia.The tidal volume (VT) was set at 10 ml/kg according to the ideal body weight in group VCV.The maximal inspiratory pressure of the anesthesia machine was adjusted to maintain the VT at 10 ml/kg in group P.Both ventilation modes were required to maintain PET CO2 within the normal range.VT,respiratory rate,minute ventilation (MV),dynamic lung compliance (Cdyn),peak and mean airway pressure (Ppeak,Pmean),mean arterial pressure (MAP) and HR were recorded at 10 min after the patients were turned to supine position and at 30 min after the patients were turned to prone position after intubation.Arterial blood samples were collected for blood gas analysis,and oxygenation index(OI) and physiologic dead space fraction (VD/VT) were calculated.Results Compared with those at 10 min after turning to supine position,Ppeak was significantly increased and Cdyn,VT and MV were decreased at 30 min after turning to prone position in both groups.Compared with group VCV,Ppeak was significantly decreased,respiratory rate and Cdyn were increased,and no significant change was found in VT,MV,OI,VD/VT,Pmean,MAP and HR in PCV group.Conclusion Compared with VCV,PCV can improve the ventilatory efficacy and reduce the influence of prone position on respiratory dynamics in the patients undergoing spinal surgery in prone position supported by a Wilson frame.