AIM: To study the protective effect of edaravone on renal injury induced by chronic intermittent hypoxia and its effect on Caspase-1 mediated pyroptosis signaling pathway in rats. METHODS: Twenty four SPF male SD rats were randomly divided into normal control group, intermittent hypoxia group, intermittent hypoxia + normal saline group and intermittent hypoxia + edaravone group, with 6 rats in each group. The four groups of rats were placed in the closed feeding chamber for modeling. The oxygen concentration in the NC group was maintained at about 21%; the IH group, IH + NS group and IH + EDA group were given regular input of pure oxygen, pure nitrogen and compressed air to form anoxic-reoxygenation cycle (60 s hypoxic period + 60 s reoxygenation period). During the hypoxic period, the oxygen concentration in the chamber was reduced to 6%-7%, and the rats in the IH + EDA group were intraperitoneally injected with edaravone at a dose of 5 mg/kg per day before modeling, while the rats in the IH + NS group were intraperitoneally injected with normal saline at the same dose per day. After 8 weeks of modeling, blood and kidney tissue samples were collected to measure the levels of Crea and Urea in each group. The pathological changes and fibrosis degree of kidney were observed under light microscope after HE and Masson staining. The content of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) were determined by chemical method. The expression levels of NLRP3, Caspase-1 and IL-1β in renal tissues were determined by immunohistochemical staining. The expression levels of caspase-1 and IL-1β in renal tissues were determined by Western blot. GSDMD and IL-18 mRNA were detected by RT-PCR. RESULTS: After intermittent hypoxia exposure, serum Crea and Urea were increased significantly (P < 0.01), renal tubules were damaged by pathology, collagen fiber deposition occurred in balloon space of renal units, MDA content was increased and SOD activity was decreased (P < 0.01). Caspase-1, NLRP3, IL-1β protein expression increased (P < 0.01 or P < 0.05), GSDMD mRNA and IL-18 mRNA amplification increased (P < 0.01); After Edaravone intervention, the above indexes showed a reverse trend compared with that after intermittent hypoxia exposure, and the pathological damage of kidney was reduced (P < 0.01 or P < 0.05). CONCLUSION: Chronic intermittent hypoxia may mediate kidney injury through oxidative stress activation of caspase-1 involved in the cell pyroptosis signaling pathway, while edaravone may inhibit the activation of pyroptosis signaling pathway by scavenging oxygen free radicals and down-regulating the level of oxidative stress in the body, thus playing a protective role in kidney.

Objective:To investigate the application value of mixed reality technology in surgical conversation of laparoscopy radical resection of gastric cancer.Methods:The prospective randomized controlled study was conducted. There were 80 family members of patients with gastric cancer who were admitted to Nanfang Hospital of Southern Medical University from June 2021 to December 2022 being selected as subjects. All patients underwent laparoscopic radical resection of gastric cancer. Based on random number table, all subjects were allocated into the control group and the experiment group. Subjects in the control group performed routine surgical conversation and subjects in the experiment group performed surgical conversation based on mixed reality technology. Observation indicators: (1) baseline data of the subjects; (2) anxiety assessment of the subjects. Measurement data with normal distribution were represented as Mean± SD, and the independent sample t test was used for inter-group comparison. Repeated measurement data were analyzed using the repeated ANOVA. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the Wilcoxon rank sum test. Results:(1) Baseline data of the subjects. A total of 80 subjects were selected for eligibility, including 40 subjects in the control group and 40 subjects in the experi-ment group. There were 44 males and 36 females, aged (40±9)years. The gender (male, female), age, education background (primary school education, middle school education, high school education, junior college education, undergraduate education, postgraduate education) were 23, 17, (39±9)years, 1, 3, 9, 16, 9, 2 in subjects of the control group, versus 25, 15, (42±10)years, 0, 8, 6, 11, 14, 1 in subjects of the experiment group, showing no significant difference in the above indicators between the two groups ( χ2=0.20, t=?1.64, Z=?0.10, P>0.05). (2) Anxiety assessment of the subjects. The scores of self-rating Anxiety Scale (SAS) and Hospital Anxiety Scale (HADS) before surgical conversation, after surgical conversation, after surgery were 41±10 and 26±5, 49±11 and 32±3, 40±13 and 15±8 in subjects of the control group, versus 44±9 and 23±3, 66±16 and 28±6, 34±14 and 8±3 in subjects of the experiment group, showing significant differences in the above indicators between the two groups ( FSAS组间=8.83, FSAS时间=40.41, FSAS交互=12.21, FHADS组间=32.42, FHADS时间=321.28, FHADS交互=6.15, P<0.05). Conclusion:Compared with traditional surgical conversation, mixed reality technology based surgical conversation can relieve the postoperative conxiety of subjects.

【Objective】 To investigate the establishment of multi-center haemovigilance (HV) and the monitoring of adverse reactions to blood donation (ARBD), in order to provide basis for the management of blood donors. 【Methods】 The operation of HV was investigated by questionnaire. The total number of blood donations (including plateletpheresis) and ARBD cases occurred in each blood center from 2014 to 2018 were analyzed. 【Results】 Among the 24 blood centers in this survey, only nine got HV operated. The incidence of ARBD of 19 blood centers that fulfilled the questionnaire was in the range of (0.003~1.151) %. The change trend of number and incidence of ARBD cases were indeterminate. 【Conclusion】 Most blood centers did not got HV established. The incidence of ARBD varied greatly and was indeterminate. The application of HV should be further improved to strengthen ARBD management.

Objective:To summarize critical cases of emergency helicopter transferring between hospitals and improve the quality and safety of critical care.Methods:The task records of Guangxi Aviation Medical Rescue Training Base from September 2017 to September 2020 were retrieved. The mission acceptance, implementation results, disease spectrum composition, pre-transfer preparation and medical intervention on board were summarized.Results:① General information: a total of 168 patients of helicopter transfer requests were registered, of which 36 patients were transferred, 35 patients were successful, 1 patient had cardiac arrest during the landing phase, and died several hours after continuous resuscitation. Of the 36 patients 30 were males and 6 were females, with median age of 50.5 (29.8, 66.0) years old, the average transfer time was (54.95±17.89) minutes, and the average transfer distance was (205.74±74.68) km. ② Disease spectrum included 11 cases of stroke (30.55%), 7 cases of trauma (19.45%), 5 cases of severe pneumonia (13.89%), 5 cases of heart and macro-vascular diseases (13.89%), 5 cases of abdominal emergency (13.89%), and 3 other conditions (8.33%).③ Severity: 31 patients (86.11%) were severe (≥15) according to acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score; 19 patients (52.78%) were high-risk emergency transport (≥6) according to Hamilton early warning score (HEWS); 6 patients (85.71% of trauma patients) were severe trauma (≥16) according to injury severity score (ISS). ④ Preparation before transfer: remote consultation was carried out to evaluate the latest state of the patient's condition, especially the respiratory and circulatory conditions. Relevant items were reviewed and emergency treatments were implemented when necessary. Targeted preparation was made for accidents that might occur during transfer, such as electrocardiogram (94.44%), blood gas analysis (94.44%), brain CT (36.11%) and other auxiliary examinations, endotracheal intubation or tracheotomy (72.22%), deep vein catheterization (91.67%), placement of gastric tube (86.11%) and urinary tube (88.89%), adjustment of sedative (38.89%), vasoactive drugs (58.33%) and drugs for dehydration and lowering intracranial pressure (33.33%), and fixation of fracture (11.11%), etc. ⑤ On-board medical intervention: cardiac monitoring, blood pressure, respiration and blood oxygen monitoring were carried out in all patients. The parameters of patients using ventilator were adjusted in time (66.67%). The dosage of patients using micropump was adjusted in time (91.67%). Other aspects included the use of sedative and analgesics (38.89%), sputum suction nursing (75.00%), all kinds of catheter nursing (endotracheal intubation/incision nursing of 72.22%, indwelling catheter nursing of 88.89%), and cardiopulmonary resuscitation for patient with cardiac arrest (2.78%).Conclusion:As the patients transferred by helicopter are mainly those of critically ill at this stage, the requirements for airborne medical equipment and rescue technology are high, and there is an urgent need to establish technical specifications and personnel training standards.

Objective: To provide reference for clinical screening of individualized therapy by detecting the drug susceptibility of primary tumor cells derived from malignant pleural effusion (MPE) of the patients with non-small cell lung cancer (NSCLC). Methods: MPE specimens were collected from 20 patients diagnosed as NSCLC by histopathology. They were separated by density gradient centrifugation cultured in vitro to remove non-tumor cells, and then primary cell lines were established. The half-inhibitory concentrations (IC 50 ) of conventional anti-tumor chemotherapy drugs on primary tumor cells were determined by the MTT method, and an absolute predictive value (R) was obtained by comparing the IC 50 with the theoretically calculated value of maximum plasma concentration (IC 50m ). Last, the R value was compared with the actual clinical efficacy of the NSCLC patients. Results: After 20 MPE samples were pretreated and cultured for 4 generations, the primary tumor cell lines passaged stably in vitro were established successfully. Papanicolaou staining confirmed that these tumor cell lines had the characteristics of cancer cells, and their purity was nearly 100% under the microscope. The MTT results showed that the invalid IC 50 values beyond the upper limit of test concentration could be further included in the following evaluation on the therapeutic effect of patients when R values were used. When R values between 0.5 and 2.0 and more than 2.0 were used for predicting the actual therapeutic effect as disease stability and disease progression, respectively, the overall consistency between R value and actual therapeutic effect was 77% (10/13) in six patients with complete history of chemotherapy. Conclusion The primary culture of tumor cells in MPF and the detection of drug sensitivity have the clinical application value in predicting the actual therapeutic effect of NSCLC patients.

The lymphatic system plays an important role in the humoral circulation, immune activity and cancer metastasis, but the morphological characteristics of this system have to be studied thoroughly in order to adapt to the modern medicine development. Lymphatic vessels are hardly observed in general cadaveric dissection since their channels are tiny and transparent. Therefore, the improvement of the inspection techniques is the key factor for further study of the lymphatic system. In the early stage of lymphatic study, the researchers could only observe the distribution of the lymphatic vessels and nodes of the mesentery, chyle cistern and thoracic duct in postprandial mammals by anatomic dissection, but were unable to investigate the entire system of the body. Great progress in the study has been made with utilizing the direct lymphatic perfusion with mercury as a medium. Then, because of the toxicity of mercury, it was replaced by indirect injection with other instances, like dye, ink, radioisotope etc, which helped achieving rapid progress in the anatomic study and clinical application. The knowledge of the lymphatic system of the body in existing textbooks is largely based on the early anatomical studies, but quite often it does not explain some of the unexpected clinical findings. In early 2000s, a modified method of lymphatic perfusion has been applied for investigating the human lymphatic system. It has been confirmed that there could be significant differences in the lymphatic distribution of individuals. This paper reviews the current investigative approaches of lymphatic distribution of the upper extremity, from a historical perspective.

OBJECTIVETo use combined G-banding and array-comparative genomic hybridization (aCGH) for the prenatal diagnosis of a fetus with 5q35 deletion syndrome.

METHODSChromosomal karotypes of the fetus and parents were analyzed with G-banding analysis. aCGH was performed to detect minor chromosomal structural abnormalities.

RESULTSThe karyotype of the fetus was ascertained as 46, XY, t(5;10)(q35;p13), and the karyotypes of the parents were normal. aCGH has identified a de novo 1.68 Mb deletion at 5q35.2q35.3 and a 1.44 Mb duplication at 10p14p13.

CONCLUSIONaCGH has a higher resolution and greater accuracy for mapping chromosomal aberrations and is a useful supplement for G banding karyptyping analysis.

Adult ; Chromosome Banding ; Chromosome Deletion ; Chromosomes, Human, Pair 5 ; genetics ; Comparative Genomic Hybridization ; Cri-du-Chat Syndrome ; diagnosis ; embryology ; genetics ; Female ; Fetal Diseases ; diagnosis ; genetics ; Humans ; Karyotyping ; Male ; Prenatal Diagnosis ; Trisomy ; diagnosis ; genetics

Objective To investigate the value of dual-exponential model intravoxel incoherent motion (IVIM) DWI and conventional single-exponential DWI model based on readout segmentation echo-planar (RS-EP) sequence in differential diagnosis of simple rhinitis and chronic hypertrophic rhinitis.Methods Totally,20 patients confirmed by pathology were enrolled in this study and all of them underwent IVIM DWI and conventional DWI.The pure diffusion (D),pseudo-diffusion (D*),perfusion fraction (f) and conventional ADC maps were obtained respectively.The quantitative parameters of anterior,middle,posterior regions of inferior nasal concha mucosa were measured.Comparative statistical analysis was performed for comparing two groups and three regions.ROC analysis was conducted to assess the diagnostic performance.Results The ADC and D values in the simple rhinitis group were (1 938.84 ± 170.46) × 10-6 mm2/s,and (1 698.91 ±145.17) × 10-6 mm2/s.In chronic hypertrophic rhinitis group,the ADC value was (1 681.76± 132.21) × 10-6 mm2/s,and the D value was (1 439.39 ± 101.26)× 10-6 mm2/s.There were significant differences between the two groups (both P＜0.05).No significant differences were found for D* and f values between two groups (both P＞0.05).ADC values increased significantly from anterior region,middle region to posterior region (all P＜0.05).No significant difference was found for D* value among three regions (P＞0.05).ROC analysis demonstrated a higher area under the curve (AUC) for D value than ADC value (0.932±0.044 vs 0.896±0.058) with sensitivity,specificity,accuracy,positive and negative predictive values of 92.31％,93.75％,90.00％,93.75％,85.71％.Conclusion Based on RS-EP sequence,both IVIM DWI model and conventional single-exponential DWI model demonstrated great value in differential diagnosis of simple rhinitis and chronic hypertrophic rhinitis,and the IVIM-derived D value exhibited a higher diagnostic performance than the conventional ADC value.

Objective To investigate the clinical value of detection of circulating tumor cells ( CTCs) classified by epithelial cell adhesion molecule ( EpCAM) in peripheral blood of patients with non?small cell lung cancer (NSCLC). Methods Peripheral blood samples (7.5 ml each time) were collected from 47 NSCLC patients. Among them, blood samples were collected at the end of each therapy?cycle in three patients for longitudinal monitoring of CTCs. CTCs were enriched by the depletion of leucocytes using a magnetic bead separation technique, stained with EpCAM, cytokeratin 7/8 and their isotypic control antibodies, respectively, and then identified and counted by multi?parameter flow cytometry. Results In the blood samples from 47 patients, EpCAM?positive CTCs were detected in 64.3%(9/14), 40.0%(4/10) and 43.5%(10/23) of patients in stages Ⅰ?Ⅱ,Ⅲ and Ⅳ, respectively. EpCAM?negative CTCs were detected in 78. 6%( 11/14 ) , 90. 0%( 9/10 ) and 91. 3%( 21/23 ) of patients in stage Ⅰ?Ⅱ, Ⅲ, and Ⅳ, respectively. The total detection rates of EpCAM?positive and EpCAM?negative CTCs were 48.9%(23/47) and 87.2%(41/47), respectively, showing a statistically significant difference between them (P<0.001). According to the stage of the cancer, there was a significant difference between the detection rates of the two types of CTCs in patients of stageⅣ( P=0.001) , but not in stageⅠ?ⅡandⅢ( P>0.05) . The number of EpCAM?negative CTCs was significantly higher than that of EpCAM?positive CTCs in all stages (P<0.05). The frequency of patients with the percentage of EpCAM?negative CTCs >90% was significantly higher in stage Ⅳ patients than that in stage Ⅰ?Ⅱ cases (P=0.030), while the frequency of patients with the percentage of EpCAM?negative CTCs between 50%~90% was significantly lower in the stageⅣthan that in the stage Ⅰ?Ⅱ patients (P=0.001). The treatment of most patients with EpCAM?negative CTCs >50%showed to be ineffective (P=0.033). Conclusion Detection of CTCs classified by EpCAM in peripheral blood is helpful in evaluating the distant metastasis and treatment effectiveness of NSCLC patients.

Objective To investigate the clinical value of detection of circulating tumor cells ( CTCs) classified by epithelial cell adhesion molecule ( EpCAM) in peripheral blood of patients with non?small cell lung cancer (NSCLC). Methods Peripheral blood samples (7.5 ml each time) were collected from 47 NSCLC patients. Among them, blood samples were collected at the end of each therapy?cycle in three patients for longitudinal monitoring of CTCs. CTCs were enriched by the depletion of leucocytes using a magnetic bead separation technique, stained with EpCAM, cytokeratin 7/8 and their isotypic control antibodies, respectively, and then identified and counted by multi?parameter flow cytometry. Results In the blood samples from 47 patients, EpCAM?positive CTCs were detected in 64.3%(9/14), 40.0%(4/10) and 43.5%(10/23) of patients in stages Ⅰ?Ⅱ,Ⅲ and Ⅳ, respectively. EpCAM?negative CTCs were detected in 78. 6%( 11/14 ) , 90. 0%( 9/10 ) and 91. 3%( 21/23 ) of patients in stage Ⅰ?Ⅱ, Ⅲ, and Ⅳ, respectively. The total detection rates of EpCAM?positive and EpCAM?negative CTCs were 48.9%(23/47) and 87.2%(41/47), respectively, showing a statistically significant difference between them (P<0.001). According to the stage of the cancer, there was a significant difference between the detection rates of the two types of CTCs in patients of stageⅣ( P=0.001) , but not in stageⅠ?ⅡandⅢ( P>0.05) . The number of EpCAM?negative CTCs was significantly higher than that of EpCAM?positive CTCs in all stages (P<0.05). The frequency of patients with the percentage of EpCAM?negative CTCs >90% was significantly higher in stage Ⅳ patients than that in stage Ⅰ?Ⅱ cases (P=0.030), while the frequency of patients with the percentage of EpCAM?negative CTCs between 50%~90% was significantly lower in the stageⅣthan that in the stage Ⅰ?Ⅱ patients (P=0.001). The treatment of most patients with EpCAM?negative CTCs >50%showed to be ineffective (P=0.033). Conclusion Detection of CTCs classified by EpCAM in peripheral blood is helpful in evaluating the distant metastasis and treatment effectiveness of NSCLC patients.