Objective To compare the incidence of complications after removal of chest drainage tube in the early and late stages after sublobectomy for non-small cell lung cancer (NSCLC), and to analyze the factors affecting postoperative pleural drainage volume (PDV), so as to explore the countermeasures and achieve rapid postoperative rehabilitation. Methods The patients with NSCLC who underwent minimally invasive sublobectomy in our hospital from January to October 2021 were enrolled. According to the median time of extubation, the patients were divided into an early extubation group (time with tube≤3 days) and a late extubation group (time with tube>3 days). The patients were matched via propensity score matching with a ratio of 1:1 and a caliper value of 0.02. The incidence of complications and perioperative parameters after removal of the thoracic drainage tube were analyzed and compared between the two groups, and univariate and multiple linear regression analyses were performed. Results A total of 157 patients were enrolled, including 79 males and 78 females, with an average age of (58.22±11.06) years. There were 76 patients in the early extubation group, 81 patients in the late extubation group, and 56 patients were in each group after propensity score matching. Compared with late extubation group, there was no significant difference in the incidence of infection after extubation (10.7% vs. 16.1%, P=0.405) or pleural effusion after extubation (5.4% vs. 3.6%, P=0.647) in early extubation group, and there was no second operation in both groups. Univariate analysis showed that smoking history (P=0.001), postoperative serum albumin reduction value (P=0.017), surgical approach (P=0.014), lesion location (P=0.027), differentiation degree (P=0.041), TNM stage (P=0.043), number of dissected lymph nodes (P=0.016), and intraoperative blood loss (P=0.016) were infuencing factors for increased postoperative PDV. Multiple linear regression analysis showed that smoking history (P=0.002), postoperative serum albumin reduction value (P=0.041), and the number of dissected lymph nodes (P=0.023) were independent risk factors for increased postoperative PDV. Conclusion There is no significant difference in the incidence of complications after extubation between early and late extubations. Preoperative smoking history, excessive postoperative serum albumin decreases, and excessive number of dissected lymph nodes during the surgery are independent risk factors for increased postoperative PDV.

Objective To determine the causal relationship between acromegaly and colon cancer by using two-sample Mendelian randomization. Methods Genetic loci closely related to acromegaly in the whole genome-wide association study (GWAS) were selected as tool variables, and the genetic data of colon cancer from different GWASs were analyzed by two-sample Mendelian randomization (MR).The inverse variance weighting method (IVW) of the random effect model was used for analysis, and MR-weighted median and MR-Egger methods were used to supplement the analysis. Results were presented as OR values. Results Four SNPs closely related to acromegaly were obtained as tool variables, and the multiplicity test of tool variables showed that P=0.59.Three methods were used to estimate causal effects.The IVW analysis were OR=1.00(0.99-1.001) and P=0.42;the MR-Egger analysis results were OR=1.00(0.99-1.001) and P=0.42;and the Weighted median analysis results were OR=1.00(1.00-1.001) and P=0.03.The sensitivity test showed that the confidence interval of the tool variable SNP passed through 0, indicating the robustness of the MR results. Conclusion Acromegaly is not an independent risk factor for colon cancer.

Objective:To evaluate the effect of general anesthesia guided by electroencephalography (EEG) monitoring on postoperative delirium (POD) in elderly patients with non-acute fragile brain function.Methods:Sixty patients of both sexes with non-acute fragile brain function, aged 65-85 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with body mass index of 18-30 kg/m 2, undergoing hip replacement, were divided into 2 groups ( n=30 each) by a random number table method: conventional general anesthesia group (group C) and general anesthesia guided by EEG monitoring group (group E). Anesthesia was maintained by intravenous infusion of propofol 50-150 μg·kg -1·min -1 and remifentanil 0.05-0.30 μg·kg -1·min -1 and intermittent intravenous boluses of rocuronium.In group E, the dose of anesthetic was reduced when the EEG burst-suppression ratio≥10% for more than 1 min or anesthesia index (AI) <40.If the situation mentioned above still existed after 1 min, the dose of anesthetic was continued to be reduced or norepinephrine was injected intravenously.In group C, the amount of intraoperative anesthesia was adjusted according to the changes in hemodynamics.Norepinephrine 4-10 μg or dopamine 1 mg was given intravenously in the light of the patients′ heart rates when intraoperative hypotension occurred.At 10 min after anesthesia induction, immediately after skin incision, immediately at the end of surgery and at 1 h after surgery, blood samples were obtained from the artery and jugular venous bulb for blood gas analysis and for calculation of jugular bulb blood oxygen content (CjvO 2), artery-jugular bulb blood oxygen content difference (Ca-jvO 2), cerebral oxygen uptake rate (CERO 2) and jugular-arterial blood lactate concentration difference (Djv-aLac). The emergence time, amounts of intraoperative anesthetics, use of noradrenaline, cumulative time of EEG burst inhibition and duration of AI<40 were recorded.The development of POD was assessed within 5 days after surgery by the confusion assessment method for the intensive care unit and the duration was recorded. Results:Compared with group C, recovery time, cumulative time of EEG burst inhibition and duration of AI<40 were significantly shortened, the intraoperative consumption of propofol and remifentanil was decreased, the requirement for intraoperative noradrenaline was increased, CjvO 2 was increased, Ca-jvO 2 and CERO 2 were decreased immediately at the end of surgery and at 1 h after surgery, the incidence of POD within 5 days after surgery was decreased, and POD duration was shortened in group E ( P<0.05). Conclusion:General anesthesia guided by EEG monitoring can reduce the development of POD in elderly patients with non-acute fragile brain function.

With the rapid development of tumor subjects and the advance of medical technology,tumor mortality is declining in spite of the increase in tumor incidence.The male survivors pay more and more attention to their prognosis to improve the quality of their life.In the meantime,whether they could produce their own offspring become the main concern of tumor patients with good prognosis.However,until now,male tumor patients,their relatives,different social sectors and even some of our health workers,havent noticed the importance of fertility preservation and long-term fertility desires of male patients with tumor which will lead to declined or even irreversible sterility induced by the lack of fertility preservation before anti-tumor therapy.It's an important way to do fertility counseling,learn the risk of their treatment plans and choose the appropriate technique of fertility preservation which will improve prognosis quality of life of male tumor patients.This article will review the effects of tumor and the treatment on male fertility,their subjective needs and concerns,main methods for fertility preservation and the domestic and foreign research present situation.

OBJECTIVE: To investigate the relationship between the eukaryotic initiation factor 3a (eIF3a)polymorphisms and chemo-sensitivity to platinum-based drug in ovarian cancer.
 METHODS: Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) analysis was performed to detect 57 cases of eIF3a polymorphic genotypes (rs3824830, rs77382849, rs10787899 and rs3740556) after platinum-based chemotherapy drugs up to 6 cycles in primary ovarian cancer. The association between these gene sites was analyzed.
 RESULTS: There were 3 genotypes for eIF3a rs3824830, named AA, GA and GG. The frequency distribution for them was 43.86%, 36.84% and 15.79% (2 cases did not detect the genotype, 3.51%), respectively. There were 2 genotypes for eIF3a rs77382849, named CC and TC. The frequency distribution for them was 85.96% and 12.28%(1 case did not detect the genotype, 1.76%), respectively. There were 3 genotypes for eIF3a rs10787899, named GG, GA and AA, respectively. The frequency distribution for them was 26.32%, 47.36% and 26.32%, respectively. There were significant difference in different genotypes between age group and FIGO stage (P<0.05). The genotype of eIF3a rs10787899 GA was easier to resist platinum drug compared with the GG genotype and the odds ratio could be increased by 2.676 (95%CI: 0.544-13.159). The genotype of eIF3a rs10787899 AA was easier to resist platinum drug compared with the GG genotype and the odds ratio could be increased by 5.419(95%CI: 0.964-30.471). Rebalanced by age and FIGO stage, there was no significant difference (P>0.05) among these genotype groups. In all blood samples, there was only one genotype for eIF3a rs3740556, named GG.
 CONCLUSION There is no mutation genotype in eIF3a rs3740556 loci. Polymorphism in the eIF3a rs3824830, rs77382849 and rs10787899 doesn't affect the response of ovarian cancer to platinum-based chemotherapy.
Antineoplastic Agents ; therapeutic use ; Eukaryotic Initiation Factor-3 ; genetics ; Female ; Genotype ; Humans ; Mutation ; Ovarian Neoplasms ; drug therapy ; genetics ; Platinum ; therapeutic use ; Polymorphism, Genetic ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

ObjectiveTo investigate current situation of creativity among inpatient high school students with internet game addiction disorder (IGAD) and its influential factors.MethodsThe participants comprised the patients in the General Hospital of Beijing Military Region meeting the diagnostic criteria for Internet Addiction( including 70 cases of high school (HSIGAD) and junior high school 65 cases (JHSIGAD) and 70 cases of high school in the school (HSIS) ).Questionnaire plus clinical interview method was used in the process of investigation,and the research tools include diagnostic criteria for Internet Addiction,Creativity Assessment Packet (CAP).And further Family environment questionnaire,Egna Minnen av Barndoms Uppfostran (EMBU) and 16PF were used for HSIGAD.ResultsThe creativity's total and each factor's score of HSIGAD( creativity's total ( 109.60 ±11.12 ),risk ( 23.77 ± 2.97 ),curiosity ( 31.51 ± 4.29 ),imagination ( 26.06 ± 3.57 ) and challenge ( 28.26 ±2.87) ) were lower than that of HSIGAD( ( 111.35 ± 12.00) (24.14 ±3.20) (32.25 ±4.26) (26.35 ±4.25)and (28.62 ±2.79) respectively),but there was no significant difference.The creativity's total and each factor's score of HSIGAD were significantly lower than that of HSIS( ( 121.27 ± 7.68 ) ( 26.17 ± 2.30) ( 35.80 ± 3.11 )(29.66 ±3.28) and (29.64 ±2.34) respectively) (P＜0.01).Multiple stepwise regression analysis found that extroversion in personality and knowledge in family environment entered the regression equation,and all had positive prediction for creativity tendency.ConclusionThe internet game addiction may slow the development of high school student's creativity.While the personality of extroversion and the family environment with esteem to knowledge were beneficial to the development of adolescent creativity tendency.

Objective To explore the relationship of personality and coping style between parents and male inpatients with internet addiction disorder. Methods 51 male inpatients with internet addiction disorder and their parents were investigated with Cattell 16PF and Coping Style Questionnaire to evaluate their personality and coping style. All data were analyzed by partial correlate analysis. Results Multi-factors of 16PF( warmth, reasoning, emotional stability, dominance, vigilance, sensitivity, abstractedness, privateness, openness to change, perfectionism, apprehension, tension ) of male inpatients were significantly correlated with father' s ( r = 0.72 ～ 0. 85 or - 0. 71 ～ - 0.93 ) or mother' s 16PF( r = 0.73 ～ 0.92 or - 0. 72 ～ - 0.81 ), bu+ non of those factors corrected with the same factor of parental. Male inpatients' coping style did not corrected with father' s, but their problem sloving, rationalization and self-accusation corrected with mother's seeking support, rationalization and avoidance respectively. Conclusion The personality of male inpatients with internet addiction disorder is affected by parental personality, but under the impact of internet addiction disorder, this kind of influence is weakened. In coping style, the father' s influence is far weaker than the mother' s, suggesting that there is father function flaw during the process of those inpatients growing up.

Objective: To study the effect of enalapril on inducible atrial fibrillation(AF) in old rats. Methods: Old male Wistar rats were randomly divided into control group(n = 12) and experimental group(n = 13). Rats in control group were fed routinely. Rats were fed with enalapril besides normal diet in experimental group for three months. Rats were then anesthetized, thoracotomy was performed and pericardium was opened to expose heart. Right atrium effective refractory period(ERP) was measured. Sinus conduction time (SCT) and sinus recovery time (SRT) were measured for evaluating sinus function. Interatrial conduction time(IACT) and atrium response to burst pacing were evaluated in vivo. Plasma angiotensinⅡ level and atrial tissue angiotensinⅡ level were determined by radioimmunoassay. Sections were cut from the tissue of atrium and stained with Masson trichrome. The ratio of the area occupied by interstitial to the total area was measured. Results: Contrast to control group,IACT and SRT were shorter in experimental group(P ＜ 0.01 and P ＜ 0.05 respectively). AF were induced in 9 rats in control group and 4 rats in experimental group(P ＜ 0.05). AngiotensinⅡconcentration was significantly decreased in right and left atrium tissues of experimental group compared with that in control group(P ＜ 0.01). A significant decrease in interstitial atrial fibrosis was presented in experimental group compared with that of control group(P ＜ 0.01). Conclusion: Inducible atrial fibrillation rate was decreased in old rats after treatment with enalapril. This effect maybe resulted from the inhibited local atrium renin-angiotensin system and improved sinus node function by enalapril.

Objective To investigate the effects of ciyelosporine-A(CsA).a calcinenrin(CAN)inhibitor,on electrophysiological propertiesof atria in canine tachycardia-induced model of AF.Methods Eighteen healthy adult mongrel canines weighing 17.0 to 23.2 kg(rangedfrom 2 to 4 years old)were randomized to 3 groups,Sham group(no pacemaker was implanted),atrial tachypacing group(ATP group)each group at baseline and after 8 weeks' tachypacing.Measurements included atrial effective refractory period(AERP),conductionvelocity(CV),wave length(WE),atrial fibrillation load and rate-adaptability. Results After 8 weeks' atrial tachypacing,ATP andCsA groups showed significant longer duration of the P wave,shorter AERP,decreased adaptation of AERE slower CV,shorter Wland longer AF duration compared to the shamg roup (all P＜0.05).AERP of the CsA group was longer than that of ATP group (P＜0.05),but there were no differences in rate-adaptability,CV,incidence of induced AF and AF duration between CsA group and ATP group.Conclusions Our results suggest that calcineurin pathway intervention by CsA have a positive effect on tachycardia-inducedelectrical remodeling of atria,but can not prevent or reverse AF.

Objective To determine whether sleep-disordered breathing (SDB) may lead to nocturnal myocardial ischemia and whether the severity of this ischemia may be relieved by nasal continuous positive airway pressure (CPAP). Methods Overnight polysomnogram examination and simultaneous 3-channel Holter monitoring were performed on 76 patients with moderate to severe SDB and no history of coronary heart disease. All the cases were treated with CPAP for one night. ST depression was defined as a ST segment decrease of more than 1 mm from baseline and lasting 1 min or more. The total duration (minutes) of ST depression was indexed to the total sleep time (minutes per hour of sleep). Results Twenty-eight patients (37%) showed ST segment depression during their sleep. Before CPAP treatment, the respiratory disturbance index (RDI) and arousal index were significantly higher during periods of ST depression than when ST segments were isoelectric, whereas no significant difference was found in blood oxygen saturation (SaO2). After the CPAP treatment of patients with ST depression, the duration of ST depression was significantly reduced from 36.8±18.9 to 11.4±13.2 min/h (P＜0.05). ST depression-related indexes, including RDI, arousal index and the percentage of sleep time spent at SaO2 below 90% (TS90/ TST), were all significantly decreased, with RDI from 63.4±23.8 to 8.1±6.6 /h, arousal index from 51.2±18.9 to 9.6±5.4 /h, and TS90/ TST from 50.6±21.4 to 12.9±14.7% (P＜0.05). Conclusion ST-segment depression is rather common in patients with moderate to severe SDB, and CPAP treatment can significantly reduce the duration of ST depression. ST depression in these patients may reflect the myocardial ischemia that really exists and the non-ischemic changes associated with recurrent SDB.