As the clinically most common endocrine system disease, thyroid disorder is a global health problem characterized by high incidence and high disease burden. Currently, surgery remains the standard treatment of most thyroid cancers; however, active surveillance remains a feasible option for treatment of low-risk thyroid disorders. As the currently most widely used approach of thermal ablation, radiofrequency ablation is a safe and effective treatment for a variety of thyroid disorders. The review presents the advances in the efficacy and complications of radiofrequency ablation for treatment of benign thyroid nodules, follicular thyroid adenoma, and primary and recurrent thyroid cancers.

Objective To investigate the relationship between two-lung ventilation (TLV) with single-lumen endotracheal tube (SLT), one-lung ventilation (OLV) with double-lumen endotracheal tube (DLT) and postoperative pulmonary complications (PPCs) after total thoracoscopic cardiac surgery. Methods The clinical data of patients who underwent totally thoracoscopic cardiac surgeries in the Guangdong Provincial People’s Hospital from October 2019 to October 2021 were retrospectively analyzed. The patients were divided into 2 group according to the type of endotracheal tube, including a SLT group and a DLT group. Baseline data, surgical variables and PPCs were compared. The influencing factors of PPCs in the two groups were analyzed by binary logistic regression analysis. Results Finally 349 patients were enrolled, including 180 males and 169 females with an average age of (50.0±14.8) years. There were 219 patients in the SLT group and 130 patients in the DLT group. There was no statistical difference in baseline data, surgical variables or PPCs between the two groups (P＞0.05). Binary logistic regression analysis showed that PPCs were related to body mass index in the SLT group (OR=0.778, 95%CI 0.637 to 0.951, P=0.014) and preoperative smoking history in the DLT group (OR=0.058, 95%CI 0.004 to 0.903, P=0.042). Conclusion For the patients who undergo totally thoracoscopic cardiac surgery, TLV with SLT and OLV with DLT show no significant association with PPCs. At the same time, PPCs are associated with body mass index in the SLT group, while associated with preoperative smoking history in the DLT group.

Objective:This study examined the development trend and research hotspot of cardiopulmonary brain resuscitation in the last ten years by a visual analysis of the literature on post-cardiac arrest brain injury.Methods:English articles were acquired from the Web of Sciences (WOS) core database. CiteSpace 5.8.R3 software was used to analyze annual publications, countries, institutions, authors. We identified the trending research areas by analyzing collaborative networks, keywords co-occurrence, burst detection analysis, timeline and time-zone diagrams.Results:The search included 10 867 articles in the WOS core database from Jan 1, 2013 to Oct 25, 2023. In the last ten years, the top 3 nations were the United States, China, and Japan, with the United States having the most citation of 3691 and an centrality of 0.47. The author with the highest number of publications was Hans Friberg from Sweden. The top 5 most frequent keywords in WOS were cardiac arrest, cardiopulmonary resuscitation, resuscitation, survival, outcome. Keyword cluster analysis showed 4 clusters, including: #0 of-hospital cardiac arrest, #1 traumatic brain injury, #2 targeted temperature management, #3 global cerebral ischemia. Keyword burst showed that the top 5 ranked by strength are mild hypothermia, emergency cardiovascular care, neuron specific enolase, cerebral ischemia, epinephrine, and the top 5 ranked by the year of burst begins are out-of-hospital cardiac arrest, cpr, epinephrine, coma, and task force. The timeline and time zone charts indicated that, starting in 2017, the main fields of study concentration were traumatic brain injury and out-of-hospital cardiac arrest. Additionally, extracorporeal membrane, intensive care, risk factors, and electroencephalography were identified as new high-frequency keywords.Conclusions:Over the past ten years, the research hotspots on post-cardiac arrest brain injury include out-of-hospital cardiac arrest, traumatic brain injury, and target temperature control. The research development trends will be extracorporeal membrane oxygenation, critical care, and EEG.

Sepsis,characterized by inadequate host responses to infection,leads to life-threatening organ dysfunction and is a major cause of mortality among critically ill patients.Among them,immunosuppression plays a crucial role in the development of sepsis.This review elaborates on the pathogenesis and immunological features of sepsis-induced immunosuppression.Then,we analyzed the current situation of immunotherapy for sepsis from the angles of restoring immune stimulation,eliminating inflammatory mediators,and improving immunity.We emphasized the need for a comprehensive analysis of the traits and immunological types of patients with sepsis,generating new approaches to improve the prognosis of sepsis based on immune targets.

OBJECTIVE To construct the quantitative evaluation system of regional clinical pharmacists’ professional ability， and provide reference for the evaluation of regional clinical pharmacists’ professional ability. METHODS Twenty-one experts from 18 hospitals in Chongqing were consulted to construct a professional ability index system for clinical pharmacists. TOPSIS model was used to calculate and obtain the expert authority index （EI）， and the weighted averaging method was used to construct the judgment matrix. Analytic hierarchy process （AHP） was used to calculate the weights of all indicators for establishing a quantitative evaluation system of regional clinical pharmacists’ professional ability according to the weights of each item. RESULTS The results of TOPSIS showed that the EI range was 0.010-0.100， and the relative authority of experts was distinguished and measured effectively. The results of AHP showed that the judgment matrix of the quantitative evaluation system met the requirements of consistency test （consistency test index CR＜0.1）. Finally， a quantitative evaluation system for regional clinical pharmacists’ professional ability was established， including 6 sub-objective items （basic ability， clinical practice ability， coordination and communication ability， publicity ability， scientific research and teaching ability， continuous improvement ability） and 25 index items （such as educational background， professional title， clinical pharmacy working years， daily theoretical skills assessment， information ability level， medication education， etc.）. CONCLUSIONS A quantitative evaluation system of regional clinical pharmacists’ professional ability has been established. Our study provides a theoretical reference for the quantitative evaluation and optimal management of regional clinical pharmacists.

Abstract: Objective To investigate the expression of serum C-C chemokine 22 (CCL22) and its receptor C-C chemokine receptor 4 (CCR4) in patients with chronic hepatitis B (CHB), and its correlation with liver function indicators and disease progression. Methods A total of 96 patients with CHB who were treated in Neijiang Traditional Chinese Medicine Hospital from October 2021 to November 2022 were recruited as the observation group, and divided into mild group (n=43), moderate group (n=36) and severe group (n=17) , according to the progress of the disease. In addition, 50 healthy people who underwent physical examination in the same hosiptal were selected as the control group. The levels of serum CCL22 mRNA, CCR4 mRNA and liver function indicators [alanine aminotrans-ferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin (ALB)] were measured. Pearson correlation analysis was performed to analyze the correlation between serum CCL22 and CCR4 levels and liver function indicators and disease severity, and logistic regression was applied to evaluate the factors affecting the progress of CHB patients. Results Compared with the control group, the levels of CCL22 mRNA, CCR4 mRNA, ALT, AST and TBIL in the observation group were obviously higher (P<0.05), the level of ALB was obviously lower (P<0.05); the expression levels of serum CCL22 mRNA, CCR4 mRNA, ALT, AST and TBIL in mild, moderate and severe groups increased in turn, while the expression level of ALB decreased in turn, with significant differences between groups (P<0.05); The levels of serum CCL22 mRNA and CCR4 mRNA were positively correlated with liver function indicators ALT, AST, TBIL levels, and negatively correlated with ALB level (P<0.05); Both CCL22 mRNA and CCR4 mRNA were positively correlated with the severity of the disease (r=0.646, 0.516, P<0.001); the expression levels of CCR4 mRNA, ALT, AST, TBIL and ALB were all factors affecting the development of CHB patients (P<0.05). Conclusions The expression of CCL22 and CCR4 in serum is closely related to liver function index and severity of CHB patients, which can provide reference for clinical evaluation and symptomatic treatment.

Objective:To explore the feasibility and efficacy of kidney transplantation with pediatric donors to pediatric recipients (PTP) according to the quality control parameters of kidney transplantation in China.Methods:From September 2011 to September 2019, the clinical data were reviewed for 147 children undergoing kidney transplantation. The general status of donors and recipients, survival rate and complications of transplantation were analyzed.The median age was 130(21-270) month and the median weight 26.0(8.5-71.5) kg. The median age of 120 donors was 12 month (4 day-180 month) and the median weight 9.3(2.5-50.0) kg.Results:After a follow-up period of 10 days to 9 years, the cumulative survival rates of patients and grafts were 97.3% and 88.8%. The cumulative survival rates of patients and grafts were 95.7% and 60.9% in en bloc kidney transplant recipients versus 96.8% and 94.2% in single kidney transplant recipients. The major complications of en bloc kidney transplantation were graft thrombosis (47.8%) and ureteral complications (17.4%). Single kidney transplantation was characterized by delayed graft function recovery (DGF, 18.6%) and acute rejection reaction (10.5%). Two cases died from donor-derived infection after transplantation, one from cytomegalovirus infection and one from epileptic seizure.Conclusions:PTP kidney transplantation is effective. Organ matching and optimal operative mode selection are essential. Preventing postoperative thrombosis for avoiding an early graft loss has remained a high priority during PTP kidney transplantation.

Stage T1 lung cancer refers to the tumor with maximum diameter≤3 cm, surrounded by the pleural membrane of the lung or viscera, and does not exceed the lobar bronchus under the bronchoscope. The prognosis is generally good, but some of them are more invasive, and more aggressive treatments are needed to achieve the best prognosis. This article reviews which T1 lung cancers are susceptible to metastasis and their risk factors. It is hoped that such patients will receive the attention of relevant scholars, and when they are encountered clinically, a more aggressive approach will be taken to extend their life expectancy．

Objective To summarize the etiology,diagnosis and treatment of three cases of duodenal perforation. Methods The data of 3 cases of children with duodenal perforation in our hospital from September 14,2016 to June 20,2017 were retrospectively analyzed. The causes,clinical features and treatment of children's duodenal perforation were summarized. Results A total of 2 males and 1 females aged 2 years,3 years and 5 years were included in the 3 cases. All 3 cases had fever history of upper respiratory tract infection before onset. Acute abdominal pain occurred after oral administration of ibuprofen several times,and all the abdominal plain films prompted pneumoperitoneum. Three cases of perforation sites were duodenal anterior wall,diameter were 0. 5-1 cm. Two cases of small amount of pneumoperitoneum were explored and repaired the duodenal perforation by 3D laparoscopic,1 case underwent laparotomy to repair the duodenal perforation due to a large number of liquid pneumoperitoneum and severe shock. Repair of 3 cases were covered with omentum. Three cases were all cured without anastomotic fistula, ulcer, adhesive intestinal obstruction or other complications. Followed-up in the department of gastroenterology,3 cases had no Helico-bacter pylori infection. Conclusion Repeatedly oral administration of ibuprofen can cause duodenal perfora-tion in children in the short term. Once the digestive tract perforation confirmed,emergency surgical explora-tion is needed. Laparoscopic repair of duodenum perforation is safe and effective and may have a faster recov-ery. We can choose exploratory laparotomy if conditions are not allowed.

Objective To investigate the clinical significance of joint application of carcinoembryionic and carbohydrate antigen 19-9 for improving the prognosis of patients with gallbladder cancer.Methods A retrospective analysis of clinical-pathological features and prognosis were conducted including 390 patients with gallbladder cancer,who were treated from January 2003 to December 2013 at Eastern Hepatobiliary Surgery Hospital of Second Military Medical University.The clinical value of joint application of careinoembryionic and carbohydrate antigen 19-9 in prognosis was explored.The survival of patients was followed up by telephone or outpatient.Continuous variables were indicated as median (average) and categorical variables were expressed as number(n).Mann-Whitney U test was applied for continuous variables.Categorical variables were compared by the Chi-square test or Fisher probability method.The survival curve was drawn by the Kaplan-Meier method.The univariate analysis and multivariate analysis of prognosis were respectively done using the Log-rank test and COX regression model.Results Of the 390 patients,327 had complete data.The median (range) follow-up time was 49 (1-123) months.Both carcinoembryionic and carbohydrate antigen 19-9 could be used to predict prognosis of gallbladder cancer.A linear combination of carcinoembryionic and carbohydrate antigen 19-9 was significantly better(0.9365) than carbohydrate antigen 19-9 (0.7619) as well as carcinoembryionic (0.7937) alone in term of specificity.Preoperative blood test carcinoembryionic and carbohydrate antigen 19-9 nature showed double-negative group had the best prognosis,with a median survival of 27.06 months,R0 radical rate was 86.1％.Doublepositive group had the worst prognosis,with a median survival of 6.17 months,R0 radical rate was 45.1％.Conclusions Combinations of pretherapeutic tumor makers carcinoembryionic and carbohydrate antigen 19-9 can improve the accuracy of predicting prognostic in patients with gallbladder cancer,and the clinical application is practical.