With the optimization of surgical technologies and postoperative management regimens, the number of lung transplantation has been significantly increased, which has become an important treatment for patients with end-stage lung disease. However, due to the impact of comprehensive factors, such as bronchial ischemia and immunosuppression, the incidence of airway stenosis after lung transplantation is relatively high, which severely affects postoperative survival and quality of life of lung transplant recipients. In recent years, with the improvement of perioperative management, organ preservation and surgical technologies, the incidence of airway stenosis after lung transplantation has been declined, but it remains at a high level. Early diagnosis and timely intervention play a significant role in enhancing clinical prognosis of patients with airway stenosis. In this article, the general conditions, diagnosis, treatment and prevention of airway stenosis after lung transplantation were reviewed, aiming to provide reference for comprehensive management of airway stenosis after lung transplantation and improving clinical prognosis of lung transplant recipients.

Objective To evaluate the value of red cell volume distribution width(RDW)in the prognosis of patients with cardiac arrest(CA).Methods Clinical data of 146 CA patients admitted to intensive care unit(ICU)of Huzhou Central Hospital from January 2018 to October 2022 were retrospectively analyzed,and the patients were divided into survival group and death group according to the prognosis during ICU stay.The clinical data of two groups were compared,and the risk factors affecting the prognosis of CA patients were analyzed by multivariate Logistic regression.Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of RDW in CA patients.The survival curve was plotted by Kaplan-Meier method.Results A total of 146 CA patients were included in the analysis,among which 49 patients survived and 97 patients died,the mortality rate of CA patients in ICU was 66.44%.The scores of acute physiology and chronic health evaluation Ⅱ,RDW,blood sodium and alanine aminotransferase in death group were significantly higher than those in survival group,the time of cardiopulmonary resuscitation was significantly longer than that in survival group,and the length of ICU stay was significantly shorter than that in survival group(P<0.05).Multivariate Logistic regression analysis showed that RDW and time of cardiopulmonary resuscitation were independent risk factors for predicting death during ICU stay in CA patients(P<0.05).ROC curve results showed that RDW predicted death in CA patients with the area under curve of 0.742,the best cut-off value was 13.95%,the sensitivity was 59.8%,and the specificity was 85.7%.Patients with low RDW had significantly higher one-year cumulative survival rate than those with high RDW(χ2=18.757,P<0.001).Conclusion RDW was an independent risk factor for predicting death during ICU stay in CA patients.

Currently COVID-19 variant virology and its prevalence both domestically and internationally have become a new norm.With the emergence of Omicron variant, the protective effect of original preventive measures against reinfection with variant strains has declined.Current prevalence of COVID-19 variant strains, the mechanisms of reinfection and the risks of reinfection in solid organ transplant recipients(SOTR)were discussed.Immunocompromised individuals, especially SOTR, face an elevated risk of multiple infections, such as seasonal influenza and respiratory syncytial virus, during high transmission seasons for respiratory viruses and require special care and protection.With the introduction of several small molecule drugs, there are now more options available for antiviral regimens.This review offered a brief overview of the characteristics of COVID-19 variant strains in the current scenario, disease incidence among SOTR in China, unique features of novel antiviral agents and optimizing the selection of diagnostic and therapeutic plans.

This article summarizes the new progress in the diagnosis and treatment strategies on drug-resistant cytomegalovirus(CMV)infections in organ transplant recipients, including the prevention and treatment medications for CMV infection, the diagnosis and treatment strategies, and the immunological treatment regimen for drug-resistant CMV infection.The article is aimed to provide references for the prevention and treatment of drug-resistant CMV infection in organ transplant recipients.

Since an outbreak of coronavirus disease 2019, there have been more than 664 million confirmed cases and more than 6.7 million deaths worldwide.The Omicron variant discovered in November 2021 has become a dominant variant in China.Compared with the general population, Omicron infection mainly presents short-term upper respiratory symptoms followed by quick recovery; solid organ transplant recipients have the characteristics of a high incidence of severe disease and high mortality after infection, and the incidence of secondary infection and rebound positivity is significantly higher than that of the general population.This review focused upon preventive strategies of solid organ transplant recipients from the perspectives of the characteristics of organ transplant recipients, general preventive strategies, vaccination and long-acting neutralizing antibodies.

Objective:To investigate the safety and efficacy of self-made multifunctional endoscopic instrument accessory stent in endoscopic mucosal dissection (ESD).Methods:A total of 80 patients who received ESD in 924th Hospital of Joint Logistic Support Force of Chinese People′s Liberation Army from May 2019 to February 2021 were selected as research object. Random number table method was used to divide patients into control group and experimental group, 40 cases in each group. The experimental group used self-made endoscopic instrument accessory stent, and the control group did not use self-made endoscopic instrument accessory stent. The length of operation, the number of instruments taken by mistake, the number of instruments polluted during operation and the infection of postoperative 3-7 days under the same operation position, operating doctors and nurses were analyzed and compared between the two groups.Results:The incidence of instruments taken by mistake, the incidence of instruments polluted during operation and the infection rate of postoperative 3-7 days were 0.9% (8/856), 1.4% (12/856) and 2.5% (1/40) in the experimental group, which in the control group were 10.8% (96/887), 11.8% (105/887) and 15.0% (6/40) respectively, there were significant differences between the two groups ( χ2=75.92, 75.76, 3.91, all P<0.05). The length of operation in the experimental group was (51.56 ± 2.32) min, and that in the control group was (79.02 ± 2.83) min, the difference was statistically significant ( t=-8.72, P<0.05). Conclusions:When the patients underwent ESD surgery, the self-made multifunctional accessory stent was used to place the required instrument accessory. The length of operation was shorter, the incidence of instruments taken by mistake, the incidence of instruments polluted during operation and the infection rate of postoperative 3-7 days were reduced, the quality of minimally invasive endoscopic surgery was improved.

OBJECTIVE：To observe the safety and other related indexes of canagliflozin in the treatment of type 2 diabetes complicated with high risk of cardiovascular disease. METHODS ：Totally 306 patients，admitted to Hainan Provincial People ’s Hospital and Haikou People ’s Hospital ，with type 2 diabetes complicated with high risk of cardiovascular disease were selected from Dec. 2018 to Apr. 2019. They were divided into observation group （153 cases）and control group （153 cases）according to random number table . The control group was treated with in sulin，metformin or sulfonylureas conventional hypoglycemic therapy ， and the observation group was treated with Canagliflozin tablets 100 mg，once a day ，po，on the basis of control group. The course of treatment was 1 year in both groups. The levels of HbA 1c，BMI，SBP，DBP and eGFR before and after treatment were observed in 2 groups，and the incidence of safety （including death from cardiovascular causes ，myocardial infarction ，ischemic stroke ， hospitalization for heart failure and death from any cause etc. ） after treatment and serious ADR/ADE （including hypogly- cemia，diabetic ketoacidosis ，fracture，acute kidney injury 68622942。E-mail：zhaixin0123@126.com etc.）during the treatment were recorded. RESULTS ：A total of 5 patients in the control group were not followed up ， in which 3 quited and 2 were lost ；and 4 patients in the observation group were not followed up ，in which 1 quited and 3 were lost . Before treatment ，there were no statistical significance in the levels of HbA 1c，BMI，SBP，DBP and eGFR between 2 groups（P＞0.05）. After treatment ，HbA1c levels of 2 groups，BMI and SBP of observation group were all significantly lower than those before treatment with the same group ；HbA1c level and SBP of observation group were significantly lower than those of control group （P＜0.05）. eGFR levels of 2 groups after treatment were significantly higher than before treatment with the same group ，while the observation group was significantly higher than that of contrl group. The incidence of death from cardiovascular causes and death from any cause in observation group were significantly lower than control group （P＜0.05）. There were no statistically significant differences in other safety indexes and the incidence of serious ADR/ADE between 2 groups（P＞0.05）. CONCLUSIONS ：Canagliflozin can significantly reduce the incidence of death from cardiovascular causes and death from any cause in type 2 diabetes patients complicated with high risk of cardiovascular disease，ameliorate blood glucose and blood pressure ，and do not increase the occurrence of serious ADR/ADE.

OBJECTIVE： To investigate the protective effect and potential mechanism of epigallocatechin gallate （EGCG） on myocardial ischemia-reperfusion injury. METHODS： H9C2 cardiomyocytes were treated with tert-butyl hydroperoxide （TBHP） to establish ischemia-reperfusion cell model. The cell viability was measured by MTS after pretreated with different doses of EGCG （3.125， 6.25， 12.5， 25， 50， 100， 200 μmol/L）， and the survival rate was calculated. The expression of apoptotic proteins （Bcl-2， Bax） in cardiomyocytes pretreated with different doses of EGCG （100， 200 μmol/L） were detected by Western blotting. Male C57BL/6 mice were randomly divided into sham operation group， model group and EGCG group （5 mg/g）， with 15 mice in each group. Sham operation group and model group were given constant volume of normal saline intragastrically， while EGCG group was given relevant medicine intragastrically， once a day， for consecutive 7 d. Twelve hours after last medication， myocardial ischemia-reperfusion injury model was established by anterior descending coronary artery ligation. The area of myocardial infarction was observed by double staining of Evan’s blue and TTC； the percentage of infarction area to cross-sectional area was calculated；SOD activity and MDA content in serum were determined by WST-1 assay； the expression of apoptotic proteins （Bcl-2， Bax） in myocardial tissue were detected by Western blotting， while the phosphorylation levels of signaling pathway related proteins （PI3K， p-PI3K， Akt， p-Akt） were also detected. RESULTS： Cell test results showed that， compared with control group， survival rate and relative expression of Bcl-2 were decreased significantly in model group， while relative expression of Bax was increased significantly （P＜0.05）. Compared with model group， survival rate of cardiomyocyte in 25， 50， 100， 200 μmol/L EGCG groups as well as relative expression of Bcl-2 in 100， 200  μmol/L EGCG groups were increased significantly， while relative expression of Bax in 100， 200 μmol/L EGCG groups were decreased significantly （P＜0.05）. Animal experiments showed that no ischemia of myocardial tissue and enlargement of cardiac cavity were observed in sham operation group. Myocardial infarction was observed in model group. Compared with sham operation group， percentage of infarction area to cross-sectional area， the serum content of MDA， the relative expression of Bax in myocardial tissue and p-PI3K/PI3K， p-Akt/Akt were increased significantly in model group， while SOD activity and relative expression of Bcl-2 were decreased significantly （P＜0.05）. Compared with model group， myocardial infarction area of mice in EGCG group was reduced， the percentage of infarction area to cross-sectional area， the serum content of MDA， the relative expression of Bax in myocardial tissue and p-PI3K/PI3K， p-Akt/Akt were significantly decreased， the activity of SOD activity and the relative expression of Bcl-2 were increased significantly （P＜0.05）. CONCLUSIONS： EGCG can protect against myocardial ischemia-reperfusion injury， the mechanism of which may be associated with inhibiting the apoptosis of myocardial cells， improving oxidation stress， regulating the expression of apoptotic protein， reducing the phosphorylation level of PI3K/Akt signaling pathway-related proteins.

Objective To detect the binding ability of the molecular probe of neuropilin-1( NRP-1) to mouse ectopic glioma by magnetic resonance imaging ( MRI) . Methods Glioma model mice were pre-pared by glioma tissue transplantation.Thirty tumor bearing mice were randomly selected for tissue anatomy(n=12) and other 18 mice were randomly divided into 3 groups:the control group ( group A) ,the probe con-trol group (group B) and the probe group (group C),which were given 20 μl saline,20 μl USPIO-PEG, 20μl USPIO-PEG-tLyP-1 through the tail vein of the mice respectively.And at 0h,6h,12h,24h after admin-istration,T2WI and T2MAPPING sequences were detected by MRI. Then the tumor bearing mice were killed immediately and the glioma tissue was used to detect the iron content by Prussian blue staining to detect the binding ability of the glioma tissue with the new molecular probe. The biological toxicity of the new molecular probe was detected by pathological staining. Results The expression of NRP-1 in glioma tissues was signifi-cantly higher than that in the liver,kidney and brain(P<0.05).The 24h relaxation time ((14.19±0.87)ms) of the glioma tissue in the C group was significantly lower than that in the B group ((25.94±0.77)ms) (P<0.05) ,and the blue staining particles in the C group were more than those in the B group(P<0.05) . Conclu-sion In the animal experiment,the molecular probe with NRP-1 as the target has obvious targeting effect and good biocompatibility,which provides a clinical basis of glioma for further clinical diagnosis.

A comprehensive evaluation on textbooks depends not only on experts' opinions but also on the first-hand feedback information from users.This research,based on the Evaluation Norm System issued by Education Department and the real situation of users(students),has set up an evaluation norm system by students for college textbooks.Through the test of this system,it is thought that it can reflect a basic picture of textbooks and is easy to be operated.