Objective:To analyze the effect of meteorological conditions on mortality and population susceptibility of patients with acute myocardial infarction (AMI) in the Shantou area and to provide a scientific basis for the local public health system to prevent AMI.Methods:The AMI mortality data recorded in the resident cause of death surveillance database of Shantou from January 1, 2015, to December 31, 2020, were collected and the distribution lag nonlinear model was used to analyze the diurnal temperature range (DTR) and relative humidity (RH) on AMI mortality and the lag effect.Results:There were 13 932 deaths due to AMI in Shantou during the study period, with a male-to-female sex ratio of 1.3∶1. There was a significant association between high diurnal temperature difference exposure and low RH exposure and AMI deaths, with both single-day lag effects appearing and reaching a maximum at lag 2 day ( RR=1.019, 95% CI: 1.000-1.039; RR=1.018, 95% CI: 1.003-1.034); the cumulative lag effect was all maximal at lag 0-14 day ( RR=1.199, 95% CI: 1.025-1.401; RR=1.279, 95% CI: 1.117-1.465). The elderly (≥75 years) and female populations were susceptible to high DTR exposure and low RH exposure conditions. Conclusions:There was a significant association between DTR and RH and mortality of AMI in Shantou with a significant lag in their effects. Both female and elderly populations ≥75 years old were susceptible populations under high DTR and low RH exposure conditions.

The incidence of obstructive sleep apnea (OSA) is higher in pregnancy than in non-pregnancy,and obesity is a major risk factor.OSA in pregnancy can lead to multiple organ dysfunction and is associated with hypertensive disorders in pregnancy,gestational diabetes mellitus,premature birth,and fetal growth restriction. Therefore,early screening and diagnosis are essential for the prevention and treatment of OSA in pregnancy.
Diabetes, Gestational ; Female ; Humans ; Obesity ; Pregnancy ; Pregnancy Complications/epidemiology* ; Premature Birth ; Risk Factors ; Sleep Apnea, Obstructive/therapy*

Objective : To establish the liver conditional knockout mouse model ofNod2gene infected byKlebsiella pneumoniae(K.pneumoniae),and to explore the role and mechanism ofNod2gene in the process of liver abscess caused byK.pneumoniaeinfections. Methods : Nod2flox/floxmice were obtained by self-crossing ofNod2flox/+mice, andAlb-Cre+mice were hybridized withNod2flox/+to obtainNod2flox/+;Alb-Cre+mice, then the above two genotypes mice were crossed to obtain liver conditional knockout mice ofNod2gene(Nod2flox/flox;Alb-Cre+) and negative control mice in the same litter(Nod2flox/flox).The genomic DNA of mice toe was extracted and amplified by polymerase chain reaction(PCR).The genotypes of offspring were identified by agar-gel electrophoresis and the livers of mice were extracted.Real-time fluorescence quantitative PCR(RT-qPCR) and Western blot were used to verify the knockout efficiency ofNod2gene in the liver.Both experimental group and control group mice were infected withK.pneumoniae,and the survival rate and pathological changes of livers were observed at different time points, and mRNA expression levels of Tumor necrosis factor α(TNF-α),interleukin 1β(IL-1β) and C-X-C motif chemokine ligand 1(CXCL1) in the livers of experimental group and control group were detected by RT-qPCR 24 h postK.pneumoniaeinfections. Results : The expression of NOD2 mRNA in the liver ofNod2flox/flox;Alb-Cre+mice decreased, and the Western blot results showed that the expression of NOD2 protein decreased.Compared with the control group, the survival rate of mice infected withK.pneumoniaein the experimental group decreased(median survival time=60.5 h,P=0.046 9) and the liver tissue showed more serious pathological damage, furthermore the mRNA expression levels of TNF-α,IL-1β and CXCL1 in the livers of experimental group were lower than those of the control group, and the difference was statistically significant(P<0.05). Conclusion NOD2 plays a protective role in the process of liver abscess induced byK.pneumoniaeinfections.

Objective:To explore the effects of secondary pulmonary hypertension(SPH)on postoperative outcomes of lung transplant recipients.Methods:The hospitalization data of 309 patients undergoing lung transplant were retrospectively analyzed. They were divided into normal(mPAP <25 mmHg, 56 cases), low-pressure(mPAP: 25 mmHg≤mPAP<40 mmHg, 155 cases)and high pressure(mPAP ≥40 mmHg, 98 cases)groups.Three groups were compared with regards to general profiles, intraoperative status, postoperative outcomes and survival rates. The postoperative patient survival was plotted by Kaplan-Meier curve and log-rank test performed. Multivariate Cox regression analysis was performed to explore the influencing factors of postoperative survival.Results:The distribution of chronic lung disease(CLD)was statistically different among 3 groups( χ2=30.837, P=0.001). Patients with different levels of pulmonary artery pressure had different decisions supported intraoperatively by extracorporeal membrane oxygenation(ECMO)( χ2=28.205, P<0.001). The 2-year survival rates of normal, low-pressure and high-pressure groups were 58.9 %, 63.9 % and 69.4 % respectively and there were no statistically significant differences( P=0.513). Multivariate Cox regression analysis indicated that preoperative cardiac function was an independent risk factor for postoperative survival. The postoperative risk of mortality was 1.796 (95 %CI: 1.078~2.991)folds higher in patients with cardiac function grade Ⅲ/Ⅳ than those with grade Ⅰ/Ⅱ( P=0.025). Conclusions:Preoperative classification of cardiac function should be emphasized in SPH patients. And surgery during early decompensated stage of cardiac function may confer a better survival.

Lumbar disc herniation (LDH) is one of the most common degenerative spinal diseases in adults and less common in adolescents. The age of onset is less than 21 years old and is defined as adolescent lumbar disc herniation (ALDH). The incidence of ALDH is only 1%-5%. However, with the accelerated pace of life, the incidence of ALDH is increasing. In recent years, the rapid development of endoscopic technology has been widely used in spinal surgery. ALDH's percutaneous endoscopic technique has achieved good results. Compared with open surgery, percutaneous endoscopic treatment can preserve more normal lumbar structures, such as ligaments, muscles, lamina and facets, minimizing the impact on pubertal growth. This article reviews the characteristics of ALDH and endoscopic treatment as an entry point.

Objective To construct lentiviral vector of late endosomal／lysosomal adaptor, mitogen-activated protein kinase and mammalian target of rapamycin activator 2 ( lamtor2) gene, and to explore its regulatory role on inflammatory response of macrophages after Klebsiella pneumoniae infection.Methods Two pairs of mouse lamtor2 short hairpin RNA (shRNA) were designed and sub-cloned into PLKO.1-puro to construct lentiviral vector, and were transfected into the murine RAW264.7 macrophage.There were two experimental groups including pLKO.1-puro shlamtor 2-1(sh1 group) and pLKO.1-puro shlamtor 2-2 (sh2 group), and the RAW264.7 cells transfected with non-treated pLKO.1-puro was set as control.The expession of lamtor2 were detected by real-time quantitative polymerase chain reaction ( RT-qPCR ) and Western blot.The levels of inflammatory factors including interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-αsecreted by the cells were detected by RT-qPCR.T test was used for comparison between groups.Results The recombinant lentiviral vector PLKO.1-shlamtor 2 transfected RAW264.7 cells successfully.The relative expressions of lamtor2 mRNA in the control group, the sh1 group and the sh2 group were 1.000 ±0.000, 0.596 ±0.125 and 0.120 ±0.080, respectively.The expression of lamtor2 in the sh2 group was significantly lower than that in the sh 1 group (t＝3.399, P＝0.015), and they were both significantly lower than the control group ( t ＝3.333 and 9.734, respectively, both P ＜0.05).After infection with Klebsiella pneumoniae, expression levels of IL-1β( t ＝15.20), IL-6 (t＝43.30) and TNF-α(t＝12.67) were significantly higher than those in the control group (all P＜0.01).Conclusion The lentiviral vector of lamtor2 can stably down-regulate the expression of lamtor2 gene in macrophages through RNA interference mechanism , which has a significant effect on the secretion of inflammatory factors of macrophages that are infected with Klebsiella pneumoniae.

Objective: To construct lentiviral vector of late endosomal/lysosomal adaptor, mitogen-activated protein kinase and mammalian target of rapamycin activator 2 (lamtor2) gene, and to explore its regulatory role on inflammatory response of macrophages after Klebsiella pneumoniae infection. Methods: Two pairs of mouse lamtor2 short hairpin RNA (shRNA) were designed and sub-cloned into PLKO.1-puro to construct lentiviral vector, and were transfected into the murine RAW264.7 macrophage. There were two experimental groups including pLKO.1-puro shlamtor 2-1(sh1 group) and pLKO.1-puro shlamtor 2-2 (sh2 group), and the RAW264.7 cells transfected with non-treated pLKO.1-puro was set as control. The expession of lamtor2 were detected by real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot. The levels of inflammatory factors including interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α secreted by the cells were detected by RT-qPCR. T test was used for comparison between groups. Results: The recombinant lentiviral vector PLKO.1-shlamtor 2 transfected RAW264.7 cells successfully. The relative expressions of lamtor2 mRNA in the control group, the sh1 group and the sh2 group were 1.000±0.000, 0.596±0.125 and 0.120±0.080, respectively. The expression of lamtor2 in the sh2 group was significantly lower than that in the sh1 group (t=3.399, P=0.015), and they were both significantly lower than the control group (t=3.333 and 9.734, respectively, both P< 0.05). After infection with Klebsiella pneumoniae, expression levels of IL-1β (t=15.20), IL-6 (t=43.30) and TNF-α (t=12.67) were significantly higher than those in the control group (all P<0.01). Conclusion The lentiviral vector of lamtor2 can stably down-regulate the expression of lamtor2 gene in macrophages through RNA interference mechanism, which has a significant effect on the secretion of inflammatory factors of macrophages that are infected with Klebsiella pneumoniae.

Objective To investigate effective approach to decrease portal venous hypertension and high perfusion of portal vein caused by small-for-size (SFS) liver graft transplantation with the aim of improving hepatocellular microcirculation.Methods Rat models with SFS liver graft (n =62) were well estab lished and divided into SFS group and trans-portal intrabepatic portosystemic shunt (TPIPSS) group.Hemodynamic parameters,histopathologically morphologic changes,postoperative complications,accumulated survival rate were recorded and analyzed.Venous filling time after liver reperfusion,hemodynamic parameters were evaluated using t test and Kruskal-Wallis test.Kaplan-Meier method was performed for survival analysis.Results Venous filling time after liver reperfusion was remarkably prolonged with the application of multihole cone-shaped tubes.Compared with SFS group,the filling time was 4-second longer in TPIPSS.At each endpoints of reperfusion within 90 mins,the portal vein pressures were lowered in the TPIPSS group than those of SFS group.Liver grafts were present with more regular structures in TPIPSS group,with no sign of hepatic sinusoid congestion or irregular clearance extension.In the aspect of postoperative complications,all the rat receivers showed ascites in the SFS group.Nevertheless,there was no ascites observed in TPIPSS rats,and 50％ rats (5/10) experienced clinical manifestations of hepatic encephalopathy.Persistent fever over 7 days was showed in 10％ rats (1/10) of SFS group and 40％ rats (4/10) of TPIPSS group,respectively.The mean survival was superior in TPIPSS group (37.2 ± 23.5) d than SFS group (17.7 ± 13.5) d,P ＜ 0.05.Conclusion TPIPSS could be a safe and feasible approach to improve portal venous hypertension caused by SFS liver graft and hepatocellular reperfusion.

Objective To investigate the clinical effect of forced-air warming system combined with infusion heating technology on recovery quality and cellular immune.Methods Fifty patients scheduled for esophagus cancer resection randomized into two groups (n =25 each):the temperature protection group (group W)and the control group (group C).The intraoperative nasopharyngeal temperature was recorded before induction (T1 ),2 hours after operation (T2 ),the end of operation (T3 ),postoperative 2 hours (T4 ).The anesthesia wakening time,the occurrence of postoperative shivering and infection,hospitalization time were also recorded.Venous blood samples were taken at T1 ,T3 ,two days (T5 )and five days after the operation (T6 )for analysis of T-lymphocyte subsets by flow cytometry.Results Compared with T1 ,the nasopharyngeal temperature was significantly de-creased at T2 ,T3 and T4 in group C, and the nasopharyngeal temperature in group W was significantly higher than those in group C at T2 ,T3 and T4 (P <0.05).The anesthesia wakening time and the occurrence of postoperative shivering in group C was significantly more than those in group C (P <0.05).Compared with T1 ,the percentage of CD4 + cells and CD4 +/CD8 + ratio were significantly decreased and the percentage of CD8 + cells increased in both groups at T3 (P <0.05).Compared with group C at T3 ,the percentage of CD4 + cells and CD4 +/CD8 + ratio were significantly increased and the percentage of CD8 + cells decreased in group W (P <0.05).Conclusion The clinical use of forced-air warming system combined with infusion heating technology can protect the patient??s body tempera-ture,shorten the anesthesia wakening time,reduce the occurrence of postoperative shivering,which protects the patient??s immune function and accelerates recovery after surgery.

Objective To investigate the effects of multimodal analgesia of parecoxib and fentanyl on perioperative immune functions in patients of hepatocellular carcinoma (HCC).Methods Eighty HCC patients scheduled for hepatectomy were randomly divided into two groups:parecoxib sodium combined with fentanyl group (group P,40 cases) and fentanyl group (group C,40 cases).The percentages of CD3 +,CD4+,CD8+,CD4+/CD8+ T cells,CD3-CD16+ CD56+ (NK),interleukin-4 (IL-4),interferon-γ (IFN-γ) and the ratio of IFN-γ/IL-4 were detected at the following time points:30 minutes before induction of anesthesia (T0),at the end of the surgery (T1),24 h after surgery (T2) and 72 h after surgery (T3).The analgesic effects were estimated by visual analogue scale (VAS) after surgery.Total fentanyl consumption and adverse effects were also recorded.Results The percentages of CD3 + T cells were significantly lower in group C than that in group P at T2 (t =2.155,P ＜0.05).The percentages of NK in group P were recovered nearly to baseline (T0) at T2,which was higher than that of group C (t =2.791,P ＜0.05).In group C,the percentages of CD3 + T cells and NK has not recovered to baseline at T3 (respectively t =3.065,3.231,P ＜ 0.05).In group P,IL-4 serum levels were significantly lower than those in group C,while IFN-γ serum levels were significantly higher than those in group C at T2 (respectively t =2.173,2.100,P ＜0.05).From T2 to T3,the ratio of IFN-γ/IL-4 significantly increased in group P than those in group C (respectively t =3.259,2.203,P ＜ 0.05).VAS scores at rest and on cough in group P were significantly lower than those in group C at 2 h,6 h,12 h and 24 h after operation (respectively t =8.661,9.726,9.147,7.109,P＜0.05;t =8.569,9.614,9.144,8.509,P＜0.05).The total fentanyl consumption in group P was lower than that in group C (t =2.636,P ＜ 0.05).There were no significant differences regarding the incidence of adverse effects between the two groups.Conclusions Perioperative multimodal analgesia of parecoxib sodium combined with fentanyl enhances the analgesic efficacy,and reduces the dosage of opioid consumption,helps recover the cell immunity function of HCC patients after hepatectomy.