Objective To investigate the correlations of computed tomography (CT), clinical, and pathological features in patients with invasive lung adenocarcinoma positive and negative for spread through air spaces (STAS). Methods A total of 236 patients with invasive lung adenocarcinoma confirmed by surgery and pathology were selected, including 118 patients in STAS-positive group and 118 patients in STAS-negative group. The clinical data, CT signs, and pathological features of the two groups were collected and analyzed. Results There was a correlation between age and the occurrence of STAS. The age of the positive group was higher than that of the negative group. Smoking history and family history of tumor had no correlation with the occurrence of STAS. CT features signs such as nodule type and shape, tumor-lung interface, lobulation sign, spiculation sign, vacuole/cavity, air-bronchogram, pleural indentation sign, vascular changes, mean diameter of tumor, mean diameter of solid component, and the percentage of tumor solid components were significantly different between patients with and without STAS. The incidence of STAS in patients with solid nodules and partial solid nodules was significantly higher than that in patients with ground glass nodules. Multivariate analysis showed that the percentage of tumor solid components, air-bronchogram sign, lobulation sign, and tumor-lung interface were independent risk factors for predicting the occurrence of STAS. Conclusion The clinical data and CT signs of patients with invasive lung adenocarcinoma are related to the occurrence of STAS. CT signs such as the percentage of tumor solid components, air-bronchogram, lobulation sign, and tumor-lung interface are of great significance to STAS prediction. Our findings provide an important basis for selection of personalized clinical treatment plans.

Objective To observe the improvement effect and mechanism of Chaishao Ruzeng capsule on mammary gland hyperplasia model rats with liver stagnation and qi stagnation.Methods The rats were injected with estradiol benzoate and unpredictable stress stimulation to replicate the model of mammary hyperplasia with liver depression and qi stagnation.Model rats were given high,medium and low doses of Chaishao Ruzeng Capsule(1.2,0.6,0.3 g·kg-1).28 consecutive days.The general state and behavioral indexes,nipple diameter and height,and pathomorphological changes of breast tissue were observed,and serum P,LH,FSH,E2,5-HT,NE,DA,MTL,VIP,SP were measured.Results Compared with the blank control group,the rats in the model group were depilated,lassitude,unresponsive,irritability,less spontaneous activity,lower sucrose preference(P<0.01),and lower body weight;The nipple diameter and height both increased(P<0.01);The degree of hyperplasia of breast lobule increased(P<0.01).The contents of E2,LH,5-TH,NE,DA,MTL and SP in serum increased,while the contents of P and VIP decreased(P<0.01).Compared with the model group,the symptoms of depilation,lassitude,unresponsiveness and irritability were significantly improved in the various dosage groups of Chaishao Ruzeng capsule,the number of autonomous activities and sucrose preference increased(P<0.05 or P<0.01).The nipple diameter and height both decreased(P<0.05 or P<0.01);The contents of P,FSH and VIP in serum were significantly increased,and the contents of E2,LH,5-TH,NE,DA,MTL and SP were significantly decreased(P<0.05 or P<0.01).Conclusions Chaishao Ruzeng capsule can alleviate sexual hormone disorder,regulate the level of neurotransmitters,improve gastrointestinal hormone abnormalities,improve liver-qi stagnation symptoms,play a role in inhibiting mammary gland hyperplasia.

Objective:To explore the development and interaction between chronotype and depressive symp-toms among middle school students in Chongqing.Methods:A total of 1208 middle school students(613 in grade 7,595 in grade 10)were surveyed for three follow-ups at 6-month intervals.Periods T1-T3 represented baseline,6 months later,and 12 months later,respectively.Chronotype and depressive symptoms were measured by the Morn-ing and Evening Questionnaire-5(MEQ-5)and the Patient Health Questionnaire-9(PHQ-9).Analyses were per-formed using SPSS 26.0 and Mplus 8.3.Results:The MEQ-5 scores were lower in T1 than in T3,and the scores were lower in T2 than in T1 and T3(F=20.08,P＜0.001),suggesting a fluctuating trend of chronotype shifting to the Evening-type first after baseline and then to the Morning-type.The PHQ-9 scores exhibited a significant differ-ence among the three-time measurements(x2/df=9.77/2,P＜0.01).But pairwise comparisons did not yield any statistically significant findings(P＞0.05).The cross-lagged panel model showed that pathways of Ti MEQ-5 scores negatively predicted Ti+1 PHQ-9 scores(βTi-Ti+1=-0.12/-0.09,P＜0.05)and TiPHQ-9 scores nega-tively predicted Ti+1 MEQ-5 scores(βTi-Ti+1=-0.07/-0.11,P＜0.05).Conclusion:Chronotype and depressive symptoms show some changes in adolescents.The more inclined adolescents are to the Evening-type,the higher the likelihood of depressive symptoms occurring later.The more severe the depressive symptoms,the greater the likeli-hood of a subsequent shift to the Evening-type.

Objective:To explore the incidence and risk factors of postoperative cardiovascular events in older orthopedic patients.Methods:The clinical data of 316 older patients undergoing orthopedic surgery from May 2018 to December 2021 in Xuanwu Hospital, Capital Medical University were retrospectively analyzed. The independent risk factors of postoperative cardiovascular events in elderly orthopedic surgery patients were analyzed.Results:Among the 316 elderly orthopedic surgery patients, 10 patients experienced postoperative cardiovascular events (event group), and 306 patients did not experience postoperative cardiovascular events (non-event group). There were no statistical differences in gender composition, age, operation method, American Association of Anesthesiologists (ASA) classification, operation time, postoperative hospital stay, nutritional status, weakness degree, ability of daily life (ADL) and the proportions of percutaneous coronary intervention (PCI) + coronary artery bypass grafting (CABG) + old myocardial infarction (OMI), hypertension, diabetes, atrial fibrillation, old cerebral infarction, peripheral artery stenosis between two groups ( P>0.05). The proportion of coronary heart disease in event group was significantly higher than that in non-event group: 6/10 vs. 19.93% (61/306), and there was statistical difference ( P<0.01). Multivariate Logistic regression analysis result showed that coronary heart disease was the independent risk factor of postoperative cardiovascular complications in older orthopedic patients ( OR = 4.63, 95% CI 1.22 to 17.56, P<0.05). Conclusions:Accompanying coronary heart disease can increase the incidence of postoperative cardiovascular events in older orthopedic patients, but cardiovascular events do not prolong the length of hospital stay.

Objective:To explore the role of SUMOylaiton of peroxisome proliferator-activated receptor γ (PPARγ) in diabetes mellitus prompted inflammation and atherosclerosis in vascular and endothelial cells.Methods:From September 2014 to January 2017, 32 Sprague-Dawley rats in 14 weeks-old were divided into sham operated group, artery injured without diabetes group, artery injured with diabetes group and ubiquitin-conjugating enzyme 9 (UBC9) transfection group (Group D) by random digits table method with 8 rats each. Model of type 1 diabetes mellitus (T1DM) and rat carotid artery balloon injury was made in the assigned group. One rat was excluded because of model failure in each group. Systolic and diastolic common carotid artery diameter and intimal thickness of injured and healthy common carotid artery were evaluated by vascular ultrasound, and the standardized common carotid artery diastolic diameter (sCADD) was calculated. Histological tests and immunohistochemical staining were performed to evaluate intimal hyperplasia, and the ratio of intimal area to media area was calculated when the media area was equal. Human umbilical vein endothelial cells (HUVEC) were cultured 24 h in high glucose medium with different duration and concentration, and the expression levels of interleukin (IL)-8 and IL-1β mRNA were determined by real time reverse transcription polymerase chain reaction (RT-PCR), the expression level of UBC9 was determined by Western blot method, SUMOylation assay kit was used to evaluate SUMOylation of PPARγ. HUVEC was cultured in vitro and PPAR was stimulated by high glucose at different concentrations and different times PPARγ SUMOylation level. UBC9 was overexpressed by lentivirus in vivo and in vitro, and the PPARγ SUMOylation level was detected.Results:The intimal thickness, intimal area and ratio of intimal area to media area 8 weeks after carotid artery injuring in sham operated group, artery injured without diabetes group and artery injured with diabetes group were increased respectively: (0.026 ± 0.018), (0.084 ± 0.007) and (0.264 ± 0.022) mm; (0.18 ± 0.09) × 10 6, (0.32 ± 0.06) × 10 6 and (1.64 ± 0.22)×10 6 μm 2; 0.345 ± 0.073, 0.570 ± 0.080 and 2.710 ± 0.220, the sCADD was decreased respectively: 0.903 ± 0.084, 0.800 ± 0.071 and 0.330 ± 0.036, and there were statistical differences ( F = 10.40, 9.40, 8.20 and 8.60; P<0.05). After HUVEC was cultured in high glucose for 24 h, the IL-8 mRNA at sugar concentrations of 10, 20 and 40 mmol/L was 1.00 ± 0.11, 3.57 ± 0.22 and 4.07 ± 0.40, the IL-1β mRNA was 1.00 ± 0.07, 3.32 ± 0.29 and 5.13 ± 0.19, and there were statistical differences ( F = 73.05 and 205.80, P<0.05). The level of PPARγ SUMOylation and UBC9 in artery injured with diabetes group were significantly lower than those in artery injured without diabetes group (0.46 ± 0.25 vs. 1.00 ± 0.21 and 0.45 ± 0.02 vs. 1.00 ± 0.07), and there were statistical differences ( P<0.05); there was no statistical difference in PPARγ between 2 groups (0.94 ± 0.07 vs. 1.00 ± 0.04, P>0.05). The UBC9 and PPARγ SUMOylation at sugar concentrations of 0, 10, 20 and 40 mmol/L were decreased respectively (0.99 ± 0.05, 0.80 ± 0.06 and 0.62 ± 0.05; 1.00 ± 0.05, 0.57 ± 0.13 and 0.55 ± 0.08), and there were statistical differences ( F = 21.02 and 14.31, P<0.05); there was no statistical difference in PPARγ (1.00 ± 0.03, 0.90 ± 0.04 and 0.91 ± 0.05; F = 3.11, P>0.05). In HUVEC cultured in high glucose medium (20 mmol/L) for 6, 12, 24 and 48 h, the UBC9 and PPARγ SUMOylation were downregulated progressively (1.00 ± 0.09, 0.75 ± 0.05, 0.70 ± 0.08, 0.38 ± 0.04 and 0.35 ± 0.03; 1.00 ± 0.03, 0.86 ± 0.01, 0.59 ± 0.01, 0.51 ± 0.11 and 0.35 ± 0.08), and there were statistical differences ( F = 36.06 and 33.13, P<0.05); but there was no statistical difference in PPARγ (1.00 ± 0.03, 1.14 ± 0.02, 1.18 ± 0.17, 0.98 ± 0.01 and 1.04 ± 0.05; F = 1.90, P>0.05). After overexpression of UBC9 in rats with diabetes, histological analysis showed that UBC9 in artery injured without diabetes group, artery injured with diabetes group and UBC9 transfection group was 1.53 ± 0.18, 1.00 ± 0.22 and 3.62 ± 0.35, there was statistical difference ( F = 5.64, P<0.05). Ultrasonic test results show that in artery injured without diabetes group, artery injured with diabetes group and UBC9 transfection group intimal thickness was increased respectively: (0.077 ± 0.015), (0.216 ± 0.007) and (0.125 ± 0.014) mm, and there was statistical difference ( F = 27.18, P<0.05). Histological analysis showed that intimal area in artery injured without diabetes group, artery injured with diabetes group and UBC9 transfection group was (0.335 ± 0.066) ×10 6, (1.053 ± 0.103) ×10 6 and (0.544 ± 0.040) ×10 6 μm 2, the ratio of intimal area to media area was 0.63 ± 0.063, 2.03 ± 0.052 and 0.93 ± 0.100, there were statistical differences ( F = 13.58 and 53.96, P<0.05). Conclusions:Diabetes mellitus could inhibit the PPARγ SUMOylaiton and prompt inflammation and atherosclerosis in vascular and endothelial cells. Upregulation of PPARγ SUMOylaiton though UBC9 overexpressioncould play a protecting role in diabetes mellitus prompted atherosclerosis.

High-altitude physiology is a basic and core discipline of high-altitude medicine and also a required course for undergraduates majoring in high-altitude medicine. At present, high-altitude physiology teaching mainly adopts the traditional teaching mode, with a monotony teaching method. MOOC is a newly emerging online course model with advanced educational concepts. Under the background of the current military reform, the MOOC combined with the traditional teaching mode in high-altitude teaching can not only comprehensively improve the teaching quality and learning ability, but also effectively enhance the competency of students in high-altitude military medicine.

Objective: To explore experience of wound treatment of extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident. Methods: On August 2nd, 2014, 98 extremely severe burn mass patients involved in August 2nd Kunshan factory aluminum dust explosion accident were admitted to 20 hospitals in China. The patients with complete medical record were enrolled in the study and divided into microskin graft group with 56 patients and Meek skin graft group with 42 patients. Split-thickness skin in area of residual skin were resected to repair wounds of patients in microskin graft group and Meek skin graft group by microskin grafting and Meek miniature skin grafting, respectively. The residual wound size on 28 days post injury and wound infection after skin grafting of patients in the two groups, and position of donor site of all patients were retrospectively analyzed. Data were processed with t test and chi-square test. Results: The size of residual wound of patients in Meek skin graft group on 28 days post injury was (59±13)% total body surface area (TBSA), which was obviously smaller than that in microskin graft group [(70±14)%TBSA, t=4.379, P<0.05]. Twenty-nine patients in microskin graft group and 11 patients in Meek skin graft group suffered from obvious wound infection after skin grafting. Wounds of patients in two groups were repaired with residual skin around wound in head, trunk, groin, armpit, and uncommon donor sites of scrotum (4 patients), vola (10 patients), and toe or finger web (8 patients). Conclusions Meek skin graft is the first choice for wound repair of extremely severe burn mass patients, with faster wound healing, less wound infection. Uncommon donor sites of scrotum, vola, and toe or finger web can also be used for wound repair in case of lack of skin.

Coronary atherosclerosis (CAS) has been recognized as a chronic inflammatory disease in recent years.As an important component of innate immunity,complement system plays an important role in the pathogenesis of CAS.Multiple components of plaque can activate complement proteins,and the activation of complement promotes the progression of plaque lesions in turn.However,recent studies have also found that some proteins of the complement system may also paly an atheroprotective role in the early stage of atherosclerosis.In addition to the direct effects,complement system is also involved in CAS-related pathological changes.Complement proteins may be promising biomarkers,as confirmed by clinical studies which suggest that circulation levels of some complement proteins can predict the risk and prognosis of CAS.This review mainly introduced the origin and activation of complement molecules inside the plaques,their important roles in the pathogenesis of CAS,and the value of complement molecules as potential predictors in clinical.

Objective:To study the therapeutic effect of Liyanling granules on chronic pharyngitis. Methods:The chronic pharyn-gitis rat models were established, and administered orally for 7 days. The influence of Liyanling granules on the pathology of pharyngeal tissue and the contents of PGE2 , IL-1β and TNF-α were observed. The blood was withdrawn to detect the whole blood viscosity and plasma viscosity, and the anti-inflammatory effects were observed in two kinds of rat models:foot pad swelling induced by carrageenin and agar-induced chronic granuloma. Results:Liyanling granule could significantly decrease the levels of PGE2 , IL-1βand TNF-α( P<0. 05 or P<0. 01) and the viscosity of blood and plasma(P<0. 05 or P<0. 01), improve the pathological morphology of rat pharynge-al tissues(P<0. 05 or P<0. 01), inhibit the swelling of foot pad induced by carrageenin and the granuloma induced by agar in rats(P<0. 05 or P<0. 01). Conclusion:Liyanling granules has a certain therapeutic effect on chronic pharyngitis in rats, and the mecha-nism may be related with the inhibition of inflammatory cytokines PGE2 ,IL-1β and TNF-α and the improvement of blood rheology.

Objective:To study the pharmacological effects of Leshibao chewable tablets for juvenile rats with anorexia. Methods:The rats were divided into 6 groups with 10 ones in each and fed with special forage for 4 weeks to establish the anorexia model of ju-venile rats. After the model establishment, from the 8th day, the treatment groups received Leshibao chewable tablets respectively at the dose of 0. 60, 0. 30 and 0. 15 g·kg-1 ·d-1 for three weeks. The general situation was observed, and the appetite and body weight were recorded during the treatment. At the end of experiment, the gastric juice amount, free gastric acidity, total gastric acidity and pepsin activity were determined, TP, ALB, TCHO, MTL and GAS were determined by kit methods. Additionally, the mice were given Leshibao chewable tablets at different doses (0. 80, 0. 40, 0. 20 g·kg-1 ·d-1 ) for 7 days, the effects of Leshibao chewable tablets on gastric emptying and intestinal propulsive function were observed. Results: Leshibao chewable tablets could significantly increase the body weight, appetite (P<0. 05 or P<0. 01), gastric juice amount, free gastric acidity , total gastric acidity and pepsin secretion (P<0. 05 or P<0. 01), significantly reduce TP, ALB and TCHO in serum (P<0. 05 or P<0. 01), significantly increase MTL and GAS contents (P<0. 05 or P<0. 01), and significantly promote gastric emptying and intestinal propulsion in mice (P<0. 05 or P<0. 01). Conclusion:Leshibao chewable tablets can significantly increase body weight and appetite, and improve digestive function re-markably, which exhibit excellent therapeutic effect in the anorexia model of juvenile rats.