ObjectiveTo evaluate the efficacy and safety of Lianhua Qingke tablets in the treatment of acute bronchitis in children with the syndrome of phlegm-heat obstructing lung. MethodA randomized， open， parallel controlled， and multi-center clinical study was conduted. Children with acute bronchitis （syndrome of phlegm-heat obstructing lung） were randomly assigned to an observation group and a control group. The control group received routine basic treatment， and the observation group was treated with Lianhua Qingke Tablets on the basis of routine basic treatment. After 7 days of treatment， the clinical efficacy， TCM efficacy， time to symptom disappearance， time to cough disappearance， and clinical safety were compared between the two groups. ResultA total of 248 children were included （124 in the observation group and 124 in the control group）. After 7 days of treatment， the total response rate in terms of clinical efficacy in the observation group was 96.8% （120/124）， which was higher than that （90.3%， 112/124） in the control group （Z=-5.034， P<0.01）. The total response rate in terms of TCM syndrome in the observation group was 97.6% （121/124）， which was higher than that （93.5%， 116/124） in the control group （χ²=-5.326， P<0.01）. The scores of physical signs and TCM symptoms in the observation group were lower than those in the control group at the time of taking medicine for 3 days and 7 days （P<0.01）. The time to symptom disappearance and the time to cough disappearance in the observation group were shorter than those in the control group （P<0.01）. Drug-related adverse reactions occurred in neither group. ConclusionLianhua Qingke tablets demonstrate a definite effect on acute bronchitis in children with the syndrome of phlegm-heat blocking lung. The tablets can significantly shorten the course of disease and relieve cough and TCM symptoms， with high safety， which is worthy of clinical application and promotion.

Objective To evaluate the efficacy of XELOX regimen as neoadjuvant chemotherapy in the treatment of stage Ⅱ and Ⅲ colon cancer.Methods The clinical data of 50 patients with clinical stage Ⅱ(T4)Ⅲ colon cancer who underwent laparoscopic radical resection at general surgery department of our hospital from January 1,2012 to January 1,2021 were retrospectively analyzed.Patients were divided into neoadjuvant chemotherapy group(NACT)and adjuvant chemotherapy group(ACT)according to whether they received neoadjuvant chemotherapy with XELOX regimen.The general clinical data,adverse reactions of chemotherapy,surgical complications,operation time,intraoperative blood loss,hospitalization time,hospitalization cost,negative conversion rate of tumor markers,tumor remission rate,tumor downstaging rate,tumor response grade after chemotherapy,postoperative disease-free survival curve,and overall survival curve were retrospectively analyzed and compared among the groups.Results There were no significant differences in operative complications,postoperative exhaust time and hospital stay between NACT group and ACT group(P＞0.05).The adverse reactions of chemotherapy,the negative conversion rate of postoperative CEA and CA19-9,the duration of operation,the amount of bleeding,and the hospitalization cost in NACT group were significantly better than those in ACT group(P＜0.05).In terms of DFS and OS survival curves,with the extension of time,the decline of the NACT survival curve was smaller than that of the ACT group,and there was a significant difference in DFS survival curve(P＜0.05),but no significant difference in OS survival curve(P＞0.05).Conclusion XELOX neoadjuvant chemotherapy is safe and effective in the treatment of stage Ⅱ(T4)and stage Ⅲcolon cancer.

Objective To explore the predictive value of the expression of serum forkhead box protein M1(FOXM1)and insulin-like growth factor 2(IGF2)on the prognosis of elderly patients with heart failure complicated with pneumonia.Methods A total of 126 elderly patients with heart failure complicated with pneumonia admitted to Handan Central Hospital from March 2021 to June 2022 were included in case group.According to the follow-up results,the 122 patients were grouped into poor prognosis group(n=33)and good prognosis group(n=89).Meanwhile,126 healthy people in the same period were included as the control group.The levels of serum FOXM1 and IGF2,forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)in the two groups(case group and control group)were measured.Spearman method was used to analyze the correlation between serum levels of FOXM1 and IGF2 and heart function classification in elderly patients with heart failure complicated with pneumonia.The predictive value of serum FOXM1 and IGF2 levels in elderly patients with heart failure complicated with pneumonia was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the levels of FOXM1(2.39±0.55 vs 1.06±0.21)and IGF2(71.33±7.96pg/ml vs 47.82±5.14pg/ml)in the case group were significantly higher(t=25.358,27.581,all P<0.05).Compared with the good prognosis group,the levels of serum FOXM1(3.87±1.06 vs 1.95±0.51)and IGF2(85.88±9.54pg/ml vs 69.14±8.73pg/ml)in the poor prognosis group were significantly higher,and the differences were statistically significant(t=13.453,9.174,all P<0.05).There were significant differences in heart function classification between the good prognosis group and the poor prognosis group,and the differences were statistically significant(χ2=7.120,P<0.05).Compared with the poor prognosis group,FEV1(1.24±0.32 L vs 1.08±0.25 L)and FEV1/FVC(55.46%±5.77%vs 52.30%±5.38%)in good prognosis group were significantly higher,and the differences were statistically significant(t=2.592,2.735,all P<0.05).The levels of serum FOXM1 and IGF2(r=0.496,0.517,all P<0.05)in elderly patients with heart failure complicated with pneumonia were positively correlated with heart function classification.ROC curve results showed that the area under the curve(AUC)of serum FOXM1 alone in predicting the prognosis of elderly patients with heart failure complicated with pneumonia was 0.854(95CI%:0.779～0.912),with sensitivity and specificity of 75.76%and 86.52%,respectively,and the optimal cut-off value of 2.75.The AUC of IGF2 alone in predicting the prognosis of elderly patients with heart failure complicated with pneumonia was 0.874(95CI%:0.802～0.927),with sensitivity and specificity of 72.73%and 85.39%,respectively,and the optimal cut-off value of 78.30 pg/ml.The AUC of the combination of the two in predicting the prognosis of elderly patients with heart failure complicated with pneumonia was greater than the AUC diagnosed by serum FOXM1 alone and IGF2 alone(Z=2.737,2.413,P=0.006,0.016).Conclusion The serum levels of FOXM1 and IGF2 were increased in elderly patients with heart failure complicated with pneumonia,indicating the combined detection of the two may have a high predictive value for the prognosis of patients.

Replacement of the temporomandibular joint (RTJ) has undergone decades of technological improvements and is now an important treatment for end-stage temporomandibular joint (TMJ) disease. The main complications of RTJ include aseptic loosening, heterotopic ossification, postsurgical infection, hypersensitivity reaction, prosthesis loosening or malposition, nerve injury and severe bleeding. Improvement in clinical technique is now the key to resolving complications. In the future, improvements in prosthetic materials may be an important development for newer iterations. With the development and popularity of TMJ surgical techniques, prosthesis-related complications will increasingly come into clinical view. This article provides a systematic review of the complications of RTJ prosthesis replacement and the measures to deal with them, and looks forward to the direction of the development of this field from the perspective of reducing complications, so as to provide a reference for clinical work.

Objective:To explore the effect of spontaneous breathing during induction of general anesthesia on atelectasis in patients undergoing laparoscopic resection of gastrointestinal tumors.Methods:A total of 60 patients aged 18-60 years scheduled for laparoscopic resection of gastrointestinal tumors under general anesthesia in the First Hospital of Shanxi Medical University from October 2021 to August 2022 were selected. The body mass index was 18.5-28.0 kg/m 2 and the American Society of Anesthesiology grade wasⅠ-Ⅱ. All patients were divided into the spontaneous breathing group (group S, 30 cases) and the controlled breathing group (group C, 30 cases) according to the random number table method. Patients in group S received 0.2-0.3 mg/kg etomidate (pumping at the speed of 200 ml/h) and 2 μg/kg remifentanil (slowly injected more than 30 s) for anesthesia induction; patients in group C received 0.2-0.3 mg/kg etomidate and 2 μg/kg remifentanil (slowly injected more than 30 s) and 0.2 mg/kg cisatracurium. After bispectral index (BIS) decreased to 80, the patients had no response to the language stimulation; and then the mask was used to closely fit the face and maintain spontaneous breathing in group S; patients in group C received manual positive pressure ventilation. Atelectasis scores were collected immediately after endotracheal intubation (T 1) and 15 min after transferring to the recovery room (T 3), and oxygenation index (OI) was collected 5 min after endotracheal intubation (T 2) and at T 3. The postoperative pulmonary complication (PPC) on the 3rd day after the operation was recorded. Results:A total of 56 patients were finally enrolled, 27 cases in group S and 29 cases in groups C. Compared with group C, the atelectasis score of group S at T 1 and T 3 decreased [T 1: (2.4±0.8) scores vs. (4.2±0.7) scores, t = -9.12, P < 0.001; T 3: (8.2±1.8) scores vs. (10.5±1.6) scores, t = -4.96, P < 0.001]. The OI increased at T 2 and T 3 in group S [T 2: (334±11) mmHg (1 mmHg = 0.133 kPa) vs. (323±13) mmHg, t = 3.45, P = 0.001; T 3: (362±23) mmHg vs. (347±25) mmHg, t = 2.31, P = 0.025]. The incidence of PPC was 20.7% (6/29) and 18.5% (5/27), respectively in group C and group S on the 3rd day after the operation, and the difference was statistically significant ( χ2 = 0.04, P = 0.838). Conclusions:Maintaining spontaneous breathing during induction of general anesthesia can reduce atelectasis caused by general anesthesia and improve oxygenation for patients undergoing laparoscopic resection of gastrointestinal tumors.

Objective:To evaluate the effect of continuous positive airway pressure (CPAP) ventilation during induction of anesthesia on perioperative atelectasis and oxygenation in elderly patients.Methods:Forty-six elderly patients of either sex, aged 65-80 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, undergoing elective cerebrovascular intervention surgery under general anesthesia, were divided into 2 groups ( n=23 each) according to the random number table method: control group (group C) and CPAP ventilation group (group CPAP). During induction of anesthesia, CPAP was set at 5 cmH 2O during spontaneous breathing, and PEEP was set at 5 cmH 2O when spontaneous breathing disappeared, and the ventilation mode was changed to pressure-controlled ventilation (PCV) mode in group CPAP. CPAP was not set, and PEEP was set at 0 cmH 2O for PCV when spontaneous breathing disappeared in group C. During anesthesia maintenance, PCV-volume guaranteed mode was used in both groups, and PEEP was set at 5 cmH 2O. Whole lung CT scanning was performed immediately after radial artery catheterization (T 0), at 1 min after endotracheal intubation (T 1), and before tracheal extubation (T 2) at the end of operation to calculate the percentage of atelectasis area at 1 cm above the right diaphragm. At T 0, T 1, T 2 and 30 min after entering postanesthesia care unit (T 3), blood samples from the radial artery were taken to record PaO 2 and PaCO 2 and calculate the oxygenation index (OI). Results:Compared with the baseline at T 0, the percentage of atelectasis area was significantly increased at T 1 and T 2 in two groups ( P<0.05); PaO 2 was significantly increased at T 1 and T 2 and decreased to T 0 level at T 3, OI was decreased at T 1 and T 2 and increased to T 0 level at T 3 in two groups ( P<0.05). Compared with group C, the percentage of atelectasis area was significantly decreased and PaO 2 and OI were increased at T 1 and T 2 in group CPAP ( P<0.05). There was no significant difference in PaCO 2 at each time point between the two groups ( P>0.05). Conclusions:CPAP ventilation during induction of anesthesia can reduce the development of perioperative atelectasis and improve the oxygenation in elderly patients.

Objective:To evaluate the effect of continuous positive airway pressure(CPAP) ventilation strategy during induction of general anesthesia on atelectasis after induction in obese patients.Methods:A total of 86 patients, aged 30-60 yr, with body mass index of 28-35 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱor Ⅲ, scheduled for elective cerebrovascular intervention under general anesthesia, were divided into 2 groups ( n=43 each) using a random number table method: CPAP group (group C) and routine group (group R). Group C received CPAP 5 cmH 2O-assisted ventilation after preoxygenation for spontaneous breathing and disappearance of spontaneous breathing. Chest CT scan and arterial blood gas analysis were performed after entering the operating room (T 1) and 5 min after endotracheal intubation (T 2) to calculate the percentage of atelectasis area and to record PaO 2. Dynamic lung compliance and plateau pressure were recorded at T 2. Mean minute ventilation under controlled breathing, P ETCO 2, and use of vasoactive drugs during induction were recorded. The occurrence of reflux and aspiration during mask ventilation was recorded. The development of pulmonary complications within 3 days after operation was recorded. Results:Compared with group R, the percentage of atelectasis area at T 2 was significantly decreased, PaO 2, dynamic lung compliance and plateau pressure were increased ( P<0.05), and no significant change was found in mean minute ventilation, P ETCO 2, requirement for vasoactive drugs and incidence of pulmonary complications in group C ( P>0.05). No reflux or aspiration was observed during mask ventilation. Conclusions:CPAP (5 cmH 2O) strategy during anesthesia induction can reduce the degree of atelectasis after induction in obese patients.

Objective:To compare the efficacy of transcatheter arterial embolization (TAE) with laparotomy in the treatment of severe liver injury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 48 patients with severe liver injury admitted to 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from December 2013 to June 2020, including 28 males and 20 females; aged 16-75 years [(45.7±6.2)years]. There were 25 patients with grade III, 15 grade IV and 8 grade V according to the American Association for the Surgery of Trauma (AAST) classification. After general treatments such as infusion and hemostasis, TAE was performed in 26 patients (TAE group) and laparotomy in 22 patients (laparotomy group). The operation time and length of hospital stay were compared between the two groups. Erythrocyte, hemoglobin and serum creatinine were compared before operation and at postoperative 1 day. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were analyzed before operation and at postoperative 1, 3, 7 days. Complications were observed.Results:All patients were followed up for 12-60 months [(17.1±9.1)months]. The operation time and length of hospital stay were (65.7±9.2)minutes and (21.6±6.6)days in TAE group, significantly shorter than (162.5±28.1)minutes and (31.5±7.4)days in laparotomy group ( P<0.05 or 0.01). There was no significant difference between the two groups referring to erythrocyte, hemoglobin and serum creatinine before operation and at postoperative 1 day (all P>0.05). There was no significant difference in ALT and AST between the two groups before operation (all P>0.05). TAE group showed ALT level of 1 154(884, 1 698)U/L, (975.3±400.9)U/L and (403.4±232.9)U/L at postoperative 1, 3, 7 days, significantly lower than 2 053(1 965, 2 132)U/L, (1 604.1±188.2)U/L and (915.3±160.5)U/L in laparotomy group (all P<0.05). TAE group showed AST level of (1 313.2±542.0)U/L, 525(302, 971)U/L and 174(84, 324)U/L at postoperative 1, 3, 7 days, significantly lower than (1 962.9±245.4)U/L, 1 478(1 089, 1 677)U/L and 837(674, 1 006)U/L in laparotomy group ( P<0.05 or 0.01). The complication rate was 26.9% (7/26) in TAE group, significantly lower than 59.1% (13/22) in laparotomy group ( P<0.05). Conclusion:For severe liver injury, TAE can significantly shorten operation time and length of hospital stay, accelerate the recovery of liver function and reduce the complication rate in comparison with laparotomy.

Objective: To investigate the value of lipid accumulation product (LAP) and visceral fat index (VAI) for prediction of metabolic syndrome (MS). Methods: Based on the 2018 Survey on Chronic Diseases and Risk Factors in Yantai City of Shandong Province, residents at ages of 45 years and older were sampled, and subjects' age, disease history, waist circumstance (WC), body mass index (BMI), blood pressure and blood lipid were collected to calculate LAP and VAI. MS was diagnosed with the a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity (JIS definition) and the recommended criteria proposed by the Chinese Diabetes Society (CDS) of Chinese Medical Association (CDS criteria), and the values of LAP and VAI for MS screening were evaluated using the receiver operating characteristic (ROC) curve analysis. Results: Totally 9 366 subjects were enrolled, including 4 340 men (46.34%) and 5 026 women (53.66%), and had a mean age of (54.49±9.73) years. According to the CDS criteria, the prevalence of MS was 24.58%, and LAP and VAI showed areas under the ROC curve (AUC) of 0.837 (95%CI: 0.828-0.846) and 0.751 (95%CI: 0.739-0.762), sensitivities of 78.82% and 63.31% and optimal cut-off values of 44.64 and 1.86 for screening of MS. According to the JIS definition, the prevalence of MS was 35.26%, and LAP and VAI showed AUC values of 0.842 (95%CI: 0.834-0.850) and 0.790 (95%CI: 0.780-0.800), sensitivities of 75.73% and 68.42% and optimal cut-off values of 42.01 and 1.67 for screening of MS. Conclusions Both LAP and VAI are effective for screening MS among middle-aged and elderly residents, and LAP presents a higher accuracy than VAI.

Objective:To understand the infection status of key human parasites in Yantai City, Shandong Province, and to provide scientific basis for establishing strategy for prevention and control of the disease.Methods:According to the "National Investigation Plan of Human Parasitic Infection Status" and implementation rules, stratified cluster random sampling method was adopted to select 39 survey sites in 10 counties (cities, districts) of Yantai City from 2015 to 2019. The respondents were residents in each survey site, with no less than 200 people in each survey site. The modified garten thick smear method (one fecal two test) and the direct smear method were respectively used to detect the eggs of intestinal worms and the trophozoites or cysts of intestinal protozoa. Besides, the transparent adhesive paper anal swab was used to detect pinworms in children aged 3 - 9 years. SPSS 18.0 software was used for statistical analysis. Comparison between infection rates was analyzed by χ 2 test or Fisher's exact probability test with 0.05 of test level. Results:A total of 8 507 people were investigated from 2015 to 2019. The total infection rate of intestinal parasites was 1.75% (149/8 507), and no protozoa was detected. A total of 4 species of intestinal worms were detected, including 1.41% (120/8 507) of whipworm, 0.16% (14/8 507) of ascaris, 0.14% (12/8 507) of pinworm and 0.07% (6/8 507) of hookworm. Among 149 cases of worm infection, 3 cases were ascaris and whipworm mixed infection, accounting for 2.01%. The infection rate of pinworm was 1.90% (11/578) in 578 children aged 3 - 9 years detected by transparent adhesive paper anal swab. From 2015 to 2019, the incidence of intestinal parasites infection first increased and then decreased, the difference was statistically significant (χ 2 = 469.38, P < 0.05). The infection rates of male and female were 1.72% (70/4 071) and 1.78% (79/4 436), respectively, with no significant difference between them (χ 2 = 0.05, P > 0.05). There was a significant difference of intestinal parasites infection rate in different age groups (χ 2 = 23.34, P < 0.05). The infection rate of intestinal parasites in ≥80 years old group was the highest with 2.84% (8/282). There was a significant difference of intestinal parasites infection rate among different professionals (χ 2 = 41.71, P < 0.05). Intestinal parasites infection rate of farmers was the highest with 2.58% (113/4 388). There was a significant difference of intestinal parasites infection rate among people with different cultural degree(χ 2 = 51.91, P < 0.05). Infection rate of illiterate people was the highest with 4.98% (16/321). Parasitic infection was detected in 10 counties (cities, districts), except Laishan District. The highest infection rate was Haiyang City (10.18%, 102/1 002), and the results of other counties (cities, districts) were lower than 1.20%. There was significant difference in infection rate in different regions (χ 2 = 433.87, P < 0.05). The infection rate in urban area was 0.51% (22/4 281), and the infection rate in rural area was 3.01% (127/4 226). The difference between urban and rural areas was statistically significant (χ 2 = 76.70, P < 0.05). Conclusion:The infection rate of intestinal parasites has been reduced to a lower level in rural area of Yantai City, and farmers are the key prevention and control population of intestinal parasites infection, so attention should be paid to strengthen the publicity of parasitic disease prevention and control.