Objective To investigate the preventive effects of lidocaine administered through different routes on cardiovascular stress responses during anesthesia tracheal intubation. Methods Total 120 patients scheduled for elective surgery under general anesthesia were randomly divided into three groups: intravenous injection group （group IV）, throat spray group （group LJ）, and control group （group CT）, with 40 patients in each. Group IV received 50 mg of lidocaine via intravenous injection 1 minute before tracheal intubation. Group LJ received 50 mg of lidocaine sprayed into the pharyngeal cavity, glottis, and subglottic area. Group CT did not receive any treatment, and the remaining procedures were performed following the routine general anesthesia induction protocol. Heart rate （HR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, and mean arterial pressure （MAP） were recorded at four time points: T₀ （before tracheal intubation）, T₁ （immediately after tracheal intubation）, T₂ （3 minutes after intubation）, and T₃ （5 minutes after intubation）. Statistical analysis of the data was performed using SPSS 22.0. Results There were no significant differences in HR at various time points within the group LJ. The changes in HR in the group IV and group CT were different statistically from those in the throat spray group. The blood pressure of patients in all three groups increased to varying degrees immediately after tracheal intubation, with the group CT showing particularly significant changes that differed significantly from both the group IV and the group LJ. The group LJ rapidly returned to levels close to those before intubation. Conclusion The preventive effects of lidocaine on stress responses during tracheal intubation were different depending on the route of administration. The inhibitory preventive effect of the throat spray method was superior to that of intravenous lidocaine, especially in preventing changes in heart rate.

Objective:To evaluate the accuracy of 3D ultrasound calibration in image guided radiotherapy for prostate cancer by taking cone beam CT calibration as the gold standard, and to analyze the risk factors of accuracy.Methods:From December 2018 to December 2021, 51 patients with prostate cancer from the Department of Radiation Oncology, First Affiliated Hospital of Hebei North University were selected as the study subjects. They received cone beam CT calibration based on bone and 3D ultrasound calibration based on soft tissue before fraction volumetric modulated arc therapy treatment three times a week. Taking cone beam CT calibration data as the gold standard, the Bland-Altman method was used to analyze the consistency of 3D ultrasound calibration data with the former. Taking 3 mm as the allowable threshold of accuracy, the calibration accuracy of 3D ultrasound relative to cone beam CT was evaluated. Logistic regression was used to analyze the risk factors affecting the accuracy of 3D ultrasound calibration.Results:A total of 765 pairs of cone beam CT and 3D ultrasound calibration data were obtained from 51 patients in left-right, superior-inferior and anterior-posterior directions. The calibration data of 3D ultrasound and cone beam CT were (1.39±0.11) and (1.13±0.07) mm in the left-right direction, (1.98±0.20) and (1.61±0.12) mm in the superior-inferior direction, (2.68±0.48) and (1.78±0.27) mm in the anterior-posterior direction, respectively, with statistically significant differences ( t=-6.42, P<0.001; t=-7.07, P<0.001; t=-7.34, P<0.001). The analysis results of Bland-Altman showed that the consistency of calibration data of the two methods were acceptable in three directions. The number of pairs of 3D ultrasound relative to cone beam CT calibration data difference <3 mm in the three directions were 676 (88.37%) on the left-right direction, 604 (78.95%) on the superior-inferior direction, and 577 (75.42%) on the anterior-posterior direction. The factors with statistically significant differences in the left-right direction included age ( χ2=18.27, P<0.001), prostate volume ( χ2=14.55, P<0.001), Charlson comorbidity index (CCI) ( χ2=8.01, P=0.005) and field range ( χ2=11.30, P<0.001). Age ( OR=2.02, 95% CI: 1.90-3.39, P=0.010) and the field range ( OR=1.45, 95% CI: 1.18-2.55, P=0.020) were the independent risk factors affecting the accuracy of 3D ultrasound calibration in the left-right direction. The factors with statistically significant differences in the superior-inferior direction included age ( χ2=80.68, P<0.001), body mass index ( χ2=35.89, P<0.001) and field range ( χ2=40.39, P<0.001). Age ( OR=1.49, 95% CI: 1.15-2.09, P=0.021) and the field range ( OR=1.10, 95% CI: 1.01-1.90, P=0.034) were the independent risk factors affecting the accuracy of 3D ultrasound calibration in the superior-inferior direction. The factors with statistically significant differences in the anterior-posterior direction included age ( χ2=46.07, P<0.001), CCI ( χ2=47.97, P<0.001) and field range ( χ2=11.86, P=0.001). Age ( OR=1.91, 95% CI: 1.22-3.45, P=0.015) and the field range ( OR=2.89, 95% CI: 1.45-3.90, P=0.001) were the independent risk factors affecting the accuracy of 3D ultrasound calibration in the anterior-posterior direction. Conclusion:The consistency and accuracy of the calibration results of 3D ultrasound relative to cone beam CT are acceptable. It is necessary to consider the patient's age and field range to reduce the impact on accuracy before conducting 3D ultrasound calibration.

As a novel and promising antitumor target, AXL plays an important role in tumor growth, metastasis, immunosuppression and drug resistance of various malignancies, which has attracted extensive research interest in recent years. In this study, by employing the structure-based drug design and bioisosterism strategies, we designed and synthesized in total 54 novel AXL inhibitors featuring a fused-pyrazolone carboxamide scaffold, of which up to 20 compounds exhibited excellent AXL kinase and BaF3/TEL-AXL cell viability inhibitions. Notably, compound 59 showed a desirable AXL kinase inhibitory activity (IC₅₀: 3.5 nmol/L) as well as good kinase selectivity, and it effectively blocked the cellular AXL signaling. In turn, compound 59 could potently inhibit BaF3/TEL-AXL cell viability (IC₅₀: 1.5 nmol/L) and significantly suppress GAS6/AXL-mediated cancer cell invasion, migration and wound healing at the nanomolar level. More importantly, compound 59 oral administration showed good pharmacokinetic profile and in vivo antitumor efficiency, in which we observed significant AXL phosphorylation suppression, and its antitumor efficacy at 20 mg/kg (qd) was comparable to that of BGB324 at 50 mg/kg (bid), the most advanced AXL inhibitor. Taken together, this work provided a valuable lead compound as a potential AXL inhibitor for the further antitumor drug development.

OBJECTIVES: Gonadal hormone is essential for the health of postmenopausal women, however, few studies have focused on the epidemiological distribution of gonadal hormones in postmenopausal women in very late postmenopausal women. This study aims to investigate and analyze the differences of serum gonadal hormone content and its influential factors among female centenarians in Hainan, China. METHODS: The questionnaire and physical examination data of 741 female centenarians and 401 elderly females in Hainan Province were collected, and venous blood samples were taken to detect the indexes of lipid metabolism, bone metabolism, and gonadal hormone. The differences of gonadal hormones and relavant factors in female centenarians were analyzed and compared. RESULTS: The serum levels of estradiol and progesterone of female centenarians were significantly higher than those of the elderly females (both P<0.001). The serum levels of estradiol and testosterone of ethnic minority centenarians were higher than those in Han nationality (P<0.001), and the serum estradiol and testosterone concentrations were relatively higher when the daily activities were more than 10 min (both P<0.05). Serum estradiol concentration was negatively correlated with apolipoprotein A-I, high density lipoprotein, triglyceride and bone formation markers such as calcium, inorganic phosphorus and vitamin D3, and was positively correlated with the special sequence of β-collagen (markers of bone resorption) (all P<0.01). CONCLUSIONS For the extremely late postmenopausal women (such as centenarians), there may be characteristic expressions of gonadal hormones, especially estradiol. There is an unprotective correlation of serum estradiol with lipid metabolism index and bone metabolism index in female centenarians, so it is necessary to evaluate the estrogen content and the use of estrogen therapy in postmenopausal women.
Aged ; Aged, 80 and over ; Centenarians ; China ; Cross-Sectional Studies ; Estradiol ; Estrogens ; Ethnicity ; Female ; Humans ; Minority Groups ; Testosterone

Objective:To investigate the level and the influencing factors of blood uric acid in monks and nuns in Wutai Mountain area, and to explore the relationship between blood uric acid level and BMI and blood lipids levels.Methods:Physical examinations and laboratory tests were performed on monks and nuns in Wutai Mountain area. There were 207 males and 261 females. Physical examination includes height, weight, blood pressure, blood uric acid, blood lipid, blood glucose and other indicators. The blood uric acid level was measured using the uricase method. Chi-square test for trend, and t test were utilized for statistical analysis. Results:The average blood uric acid level of the monk and the nun was (372±6) μmol/L and (290±4) μmol/L, respectively. Obviously, the average blood uric acid level of the monk was significantly higher than it in the nun ( t=11.636, P<0.01). The total incidence rate of hyperuricemia, which was diagnosed when the blood uric acid level was higher than 420 μmol/L in males and the blood uric acid level was higher than 360 μmol/L in females. In particular, the incidence rate of hyperuricemia was much higher in the monk (24.3%, 50/207) than in the nuns (13.4%, 35/261) ( χ2=8.966, P<0.01) . Analysis by age, the prevalence of hyperuricemia in men was 20.3%(42/207) before the age of 50, which was higher than that after the age of 50 (3.9%, 8/207) ( χ2=26.3, P< 0.01); The prevalence of hyperuricemia in women before the age of 50 was 2.7%(7/261), which was lower than that after the age of 50 (10.7%, 28/261) ( χ2=13.51, P<0.01). The uric acid level of men and women between 50-60 years old, showed the opposite trend. The level of uric acid in men decreased and increased in women. In addition, the prevalence of triglyceride abnormalities and overweight was more significantly in monks and nuns with high uric acid than those with the normal uric acid level [71.8%(61/85) vs 45.2%(173/383), χ2=19.68, P<0.01; 54.1%(46/85) vs 19.8%(76/383), χ2=42.4, P<0.01]; while no significant difference of total cholesterol and blood glucose levels was observed between these two groups. Conclusion:There are differences in blood uric acid levels among Wutai Mountain area monks and nuns of different ages and genders. The level of blood uric acid in male is significantly higher than that in female. Lipid metabolism and over weight are closely related to elevated level of the uric acid, which might be the risk factors of uric acid abnormality in Wutai Mountain population.

Objective To investigate an outbreak of norovirus GII gastroenteritis in a school, and explore the causes, transmission routes and risk factors of the outbreak, and to provide a scientific basis and experience for effective control of outbreaks of acute gastroenteritis in schools. Methods A case study of an acute gastroenteritis outbreak in a school in Wujin District, Changzhou was conducted by field epidemiological investigation. Anal swab samples of patients and controls were collected, and enterovirus nucleic acid was detected by real-time fluorescent PCR. Results From December 12 to December 17, 2019, a total of 185 cases were identified, all of them from students of the school, with an incidence rate of 3.84% (185/4,822). All of the cases were distributed in three (7^th/8^th/9^th) grades of the school, with attack rates of 5.38% (31 / 576), 18.71% (104 / 556) and 9.06% (50 / 552) in 7^th, 8^th and 9^th grade, respectively, showing a significant difference among the grades (χ²=54.47，P＜0.05). The attack rate of each floor of the teaching building from the first to fifth floor was 2.17% (5/230), 7.51% (26/346), 15.77% (53/336), 17.11% (65/380), and 6.38% (25/392), respectively, showing a statistically significant difference among different floors (χ²=55.66，P＜0.05). A total of 32 anal swabs were collected, including 12 patients, 10 control students and 10 workers in the canteen. Of them, 9 specimens of the patients and 1 specimen of the workers were positive for norovirus type GII. Conclusion The school outbreak of acute gastroenteritis was caused by norovirus GII. Close contact between students was the main mode of transmission. A hidden infection of canteen staff may be related to this outbreak. It is important to promote popular science of norovirus prevention and to enhance the awareness of the risks of the virus.

Objective To investigate the characteristics of serum lipid levels in centenarians in Hainan province.Methods A total of 899 centenarians were enrolled.Fasting venous blood samples were collected,and serum levels of total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol (HDL-C),apolipoprotein A-1 (Apo A1),apolipoprotein B(Apo B) and lipoprotein (a) [Lp (a)] were determined.Characteristics of serum lipid levels in centenarians with different age and gender were analyzed.Results The ratio of male to female in this study was 1 ∶ 4,101 years of age comprised the largest proportion(20.4 ％,183 cases),and the highest age was 109 years old for men and 116 years old for women.People aged 102 years had the highest levels of TC,TG,LDL-C and Apo B,and also had the lowest levels of HDL-C and Apo A1.Serum levels of TC and LDL-C reached the peak at the age of 102 years and showed downward trends year by year.Serum levels of TC,TG,LDL-C,Apo A1 and Apo B were lower in males than in females(P＜0.01),and HDL-C had no significant difference between males and females(P ＞0.05).The detection rates for abnormal serum lipid levels were higher in females than in males(P＜0.01).Serum Lp(a) level was higher in females than in males.Conclusions Serum lipid levels show a peak expression at a certain age in centenarians of Hainan,and the types and ratio of abnormal blood lipids are higher in female centenarians than in male centenarians.

Objective To evaluate the clinical significance of serum thrombospondin-1 (TSP-1) in systemic lupus erythematosus (SLE), and explore its possible involvement in SLE pathogenesis. Methods One hundred and thirty-eight patients diagnosed with SLE, including 124 cases of females and 14 males, as well as 60 healthy controls were recruited into this study. Enzyme-linked immunosorbent assay (ELISA) was used to determine serum TSP-1 expression level between the two groups. Spearman correlation analysis method was used to analyze the correlation between TSP-1 level of complement 3, complement 4, anti-double-stranded DNA, Rheumatoid factor and systemic lupus erythematosus disease activity index (SLEDAI). Results TSP-1 level in healthy control group was much higher than that in SLE patients. TSP-1 serum levels in SLE patients was positively correlated with complement 3 (r=0.386, P<0.01), complement 4 (r=0.301, P<0.01), and negatively correlated with anti-double-stranded DNA (r=-0.221, P=0.009), RF (r=-0.186, P=0.029) and SLEDAI (r=-0.273, P=0.001). Conclusion TSP-1 may play an immune-regulatory role in the development of SLE by inhibiting inflammation and autoantibody production. It could become a potential therapeutic target for the treatment of SLE.

After the status quo of medical treatment quality management and its relevant problems were analyzed, how to build the platform for medical treatment quality management was proposed by establishing perioperative clinical data center and intelligent management engine through data sharing, integration and reconstitution based on the present hospital information system in order to standardize perioperative medical behaviors and protect the safety of patients.

BACKGROUND:Endplate cartilage degeneration initiates intervertebral disc degeneration. AMP-activated protein kinase (AMPK) regulates the formation and degradation of cartilage. OBJECTIVE:To explore the role of AMPK in an in vitro natural degeneration model of chondrocytes derived from endplate of rat intervertebral discs. METHODS:Morphology of in vitro subcultured endplate chondrocytes of rat intervertebral discs at passages 0, 2, and 5 were observed under an inverted microscope fol owing cytoskeleton staining. Chondrocyte phenotype, proliferation, and the cartilage marker genes (type II col agen, proteoglycan, SOX-9, matrix metal oproteinase-3 and-13), and AMPK phosphorylation were determined by toluidine blue staining, MTT assay, real-time PCR analysis, and western blot assay, respectively. RESULTS AND CONCLUSION:The altered morphology, decreased proliferation ability, and phenotype loss were observed in chondrocytes with increased passage number. Gene expression of type II col agen, proteoglycan, SOX-9 was significantly decreased;while gene expression of matrix metal oproteinase-3 and-13 was significantly increased in endplate chondrocytes at passage 5 compared with those at passages 0 and 2. AMPK phosphorylation in endplate chondrocytes at passage 5 was significantly decreased. These findings indicate that AMPK phosphorylation is involved in in vitro natural degeneration of chondrocytes derived from the endplate of rat intervertebral discs, and the degeneration of endplate chondrocytes and intervertebral discs can be inhibited through the regulation of AMPK activity.