Objective:To compare the effects of transverse abdominis plane block and incision infiltration anesthesia on the early postoperative recovery in the patients undergoing thoracoscopic lung resection with general anesthesia.Methods:Eighty American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients, regardless of gender, aged 50-78 yr, with body mass index of 18-30 kg/m 2, scheduled for elective thoracoscopic lung resection under general anesthesia, were divided into 2 groups ( n=40 each) using a random number table method: incision local infiltration group (group D) and transverse abdominis plane block group (group E). In group E, the patients were changed to the lateral position after completion of anesthesia induction, ultrasound-guided transverse abdominis plane block was performed on the affected side, with 0.25% ropivacaine hydrochloride 30 ml injected. In group D, infiltration anesthesia with 0.25% ropivacaine hydrochloride was performed before incision. Postoperative patient-controlled intravenous analgesia was carried out, and flurbiprofen axetil was intravenously injected for rescue analgesia when the numerical rating scale score at rest >3 or numerical rating scale score≥6 while coughing. Quality of Recovery-15 scale scores were assessed at 1 day before surgery and 24 and 48 h after surgery. Plasma concentrations of interleukin-6 (IL-6) and IL-1β were measured by enzyme-linked immunosorbent assay before incision, at the end of surgery, and at 24 h after surgery. The amount of remifentanil used during surgery, the number of effective pressing times of patient-controlled analgesia within 48 h after surgery, requirement for rescue analgesia, first ambulation time after surgery, time to first flatus, length of hospital stay, and occurrence of nausea and vomiting and pulmonary infection within 48 h after surgery were recorded. Results:Compared with group D, Quality of Recovery-15 scale scores were significantly increased, the amount of remifentanil used during surgery and the number of effective pressing times of patient-controlled analgesia were reduced, the rate of rescue analgesia was decreased, the time to first rescue analgesia was prolonged, and the time to first flatus was shortened in group E ( P<0.05). There were no significant differences in the plasma concentrations of IL-6 and IL-1β at various time points, time to first ambulation after surgery, length of hospital stay, and incidence of nausea and vomiting and pulmonary infection between the two groups ( P>0.05). Conclusions:Compared with incision infiltration anesthesia, transverse abdominis plane block can reduce intraoperative consumption of opioids, alleviate postoperative pain, and promote early postoperative recovery when used for thoracoscopic lung resection under general anesthesia.

ObjectiveTo investigate the clinical characteristics of dysphagia after brainstem stroke, and rehabilitation effect and influencial factors for it. MethodsA retrospectively analysis was conducted in patients who were diagnosed as dysphagia after brainstem stroke in the Beijing Bo'ai Hospital from April, 2018 to December, 2021. The following data were collected: the general information (gender, age, course of disease, and time of treatment), the result of videofluoroscopic swallowing study (VFSS), the Dysphagia Severity Scale (DSS) score before and after treatment, the scores of Fugl-Meyer Assessment (FMA), FMA-Balance (FMA-B), National Institutes of Health Stroke Scale (NIHSS) and Barthel index (BI), Mini-Mental State Examination (MMSE), and whether oral feeding. Based on the result of VFSS, all patients were divided into non-cricopharyngeal achalasia group (control group) and cricopharyngeal achalasia group (observation group). ResultsA total of 60 patients were collected, with 29 in the control group and 31 in the observation group. The scores of FMA, FMA-B, BI and MMSE were higher (|t| > 3.281, P < 0.01), and the NIHSS score was lower (t = 4.390, P < 0.001) in the observation group than in the control group. Before treatment, the score of DSS was significantly lower in the observation group than in the control group (t = 5.785, P < 0.001); after treatment, the scores improved in both groups (|t| > 5.387, P < 0.001), and no significant difference was found between two groups (t = 1.675, P = 0.099); however, the d-value was more in the observation group than in the control group (t = -2.729, P = 0.008). There was no significant difference in the rate of oral feeding (χ² = 2.742, P = 0.098). In the control group, there were differences in the scores of NIHSS, FMA-B, BI and DSS between patients with oral feeding and those with nasal feeding (|t| > 2.429, P < 0.05); however, no significant difference was found in all factors in the observation group (P > 0.05). The DSS score was the influence factor of oral feeding in the control group (OR = 3.947, 95%CI 1.361 to 11.450, P = 0.012), and no influencing factor was found in the observation group. ConclusionAmong the patients with dysphagia after brainstem stroke, less accompanying disorders and more severe dysphagia were found in those with cricopharyngeal achalasia. All patients improved in dysphagia after treatment, and the rehabilitation effect of cricopharyngeal achalasia was better. The score of DSS relates with oral feeding in non-cricopharyngeal achalasia patients, and there was no specific influencing factor in cricopharyngeal achalasia patients.

Objective:To analyze the factors influencing dysphagia after an injury to the cervical spinal cord (CPCI) to provide a basis for clinical screening and intervention.Methods:A total of 110 CPCI patients with dysphagia were divided into a severe dysphagia group ( n=19), a mild dysphagia group ( n=35), and a control group ( n=56) according to their functional oral intake scale scores. Data on gender, age, level of injury, degree of damage, duration of injury, causes of injury, surgical mode, tracheotomy status, occurrence of pneumonia and pharynx swelling were collected. Univariate and multivariate logistic regressions were evaluated to identify factors affecting swallowing. Results:The regressions highlighted age, the severity of the spinal cord injury, tracheotomy status, and the occurrence of pneumonia and pharyngeal swelling during hospitalization as the best predictors of swallowing difficulties. Multifactoral logistic regression analysis revealed that undergoing tracheotomy and catching pneumonia during hospitalization were major risk factors for severe dysphagia.Conclusions:Tracheotomy and pneumonia during hospitalization are useful predictors of severe dysphagia after a cervical spinal cord injury.

Objective:To explore the feasibility of pretargeting technique for immunoPET with epidermal growth factor receptor (EGFR) monoclonal antibody in EGFR positive/negative tumor bearing mice.Methods:Cetuximab- Trans-cyclooctene (TCO)was obtained by modifying Cetuximab with TCO- N-hydroxysuccinimide (NHS). 2, 2′-((6-amino-1-(4, 7-bis-(carboxymethyl)-1, 4, 7-triazonan-1-yl)hexan-2-yl)azanediyl)-diacetic acid (L-NETA)was used as a chelating agent to prepare the radioligand 68Ga-L-NETA-tetrazine (Tz), then the labeling rate and in vitro stability of the product were determined. Human basal breast cancer cells MDA-MB-468 (EGFR+ ) and MDA-MB-231 (EGFR-) were cultured in vitro. In vitro experiments were performed to explore the specificity of the probe and the feasibility of pretargeting technique. Nude mice (Balb/c-nu) bearing xenografts of the above two cell lines were established. Cetuximab-TCO (50 μg) was injected into the tumor-bearing mice in advance, then 68Ga-L-NETA-Tz was injected at different time points (48, 36, 24 and 12 h), and pretargeting was realized through " click chemistry" . Small-animal PET imaging and biodistribution were performed to evaluate pharmacokinetic properties and specificity of the probe. The one-way analysis of variance was used to compare the data. Results:The 68Ga-L-NETA-Tz molecular probe was successfully prepared with the labeling yield >95%, and the radiochemical purity was >95% after 2 h. Cetuximab-TCO and 68Ga-L-NETA-Tz were added to MDA-MB-468 cells successively, and the cell uptake rate reached (0.69±0.04)% at 1 h, which demonstrated the feasibility of the pretargeting technique. PET imaging and biodistribution results showed that the best imaging results were obtained in 36 h pre-injection group, in which the tumor uptake was the highest ((0.77±0.05) percentage activity of injection dose per gram of tissue (%ID/g), 1 h) and the tumor/muscle ratio was optimal (4.67±0.46); the tumor uptake in the blocking group, the group without injecting Cetuximab-TCO, and the MDA-MB-231 group were significantly lower ((0.35±0.01), (0.39±0.05), (0.45±0.10) %ID/g; F=15.50, P=0.002). Conclusions:EGFR targeted immunoPET imaging is successfully performed in mouse models of breast cancer by injecting Cetuximab-TCO and 68Ga-L-NETA-Tz successively. It provides an effective method for immunoPET imaging of monoclonal antibodies.

ObjectiveTo investigate the tongue movement of swallowing food with different volumes and viscosities in healthy adults by B/M ultrasound. MethodsFrom November 1, 2021 to April 15, 2022, 61 healthy adults were recruited from those who underwent ultrasound examination in Beijing Bo'ai Hospital. The objects were ask to swallow 5 mL water, 15 mL water, 5 mL semi-liquid yogurt and 5 mL solid yogurt. Then B/M ultrasound was used to record the phase I time, phase II time, maximum amplitude and maximum velocity of tongue movement. ResultsThe phase I time was the least as swallowing 5 mL water (|Z| > 3.871, P < 0.001). The phase II time was less asswallowing 5 mL water than that of swallowing 15 mL water and 5 mL semi-liquid yogurt (|Z| > 2.61, P < 0.001). The maximum amplitude of tongue movement was the most as swallowing 15 mL water (|Z| > 8.888, P < 0.001). There was no significant difference in the maximum velocity of tongue movement among the four swallowing tasks (χ² = 0.833, P > 0.05). ConclusionFood of different viscosities and different volumes can affect tongue movement. The use of B/M ultrasound is an easy, radiation-free and cost-effective method for the assessment of swallowing.

Objective To explore the factors related to the recovery of nil per os (NPO) patients after stroke by retrospective data analysis, and to establish a predictive model.Methods The information of demographics, evaluation and treatment of 141 stroke patients admitted to the Hearing and Language Department in Beijing Bo'ai Hospital from April, 2017 to November, 2020 were selected. The predictive model was established by univariate analysis and Logistic regression. The fitting degree and discriminant validity of the model were evaluated by Hosmer-Lemeshow (H-L) test and receiver operating characteristic (ROC) curve. Other 121 patients with post-stroke dysphagia from December, 2020 to November, 2021 were used as the validation set to verify the model.Results For univariate analysis, National Institute of Health Stroke Scale (NIHSS) score, drinking water test results, autonomous cough ability, cough after swallowing, movement ability of tongue and jaw, and electrical stimulation treatment were significantly associated with the outcome (H=65.803, χ2 > 4.623, P<0.05). Multivariate Logistic regression analysis showed that NIHSS score (X1, OR=0.772, 95%CI 0.64 to 0.82, P<0.001), spontaneous cough ability (X2, OR=5.116, 95%CI 1.28 to 20.41, P=0.021), and electrical stimulation during treatment (X3, OR=94.718, 95%CI 5.65 to 1589.26, P=0.002) were independent factors for the outcome of swallowing function. Thus, the predictive model was P=11+e−(2.368−0.325X1+1.632X2+4.551X3) P = 1 1 + e - ( 2.368 - 0.325 X 1 + 1.632 X 2 + 4.551 X 3 ) , which was well fitting (P=0.845), with the largest area under curve (0.884). The overall accuracy of the model in the validation set was 91.7%.Conclusion The patients with dysphagia would like to recover well if he/she was with lower NIHSS scores and normal autonomous cough ability; meanwhile, the addition of electrical stimulation therapy in comprehensive rehabilitation may be helpful. A predictive model has been established, which needs a further research.

Objective To investigate the diagnostic value of ultrasound and MRI in fetal bronchopulmonary sequestration (BPS). Methods The 7 pregnant women with suspected fetal BPS were examined with a 1.5 T MR unit within 24 h after prenatal ultrasound in Hubei Maternal and Children's Hospital during July 2013 to February 2015. The imaging protocol included half-fourier acquisition single shot turbo SE (HASTE), true fast imaging with steady state precession (True FISP) in axial, frontal and sagittal planes relative to the fetal thorax. Prenatal MRI findings have been compared with postnatal enhanced computed tomography or biopsy. Results The locations of BPS were in left side in 5 cases and in right side in 2 cases. One case was complicated with congenital cystic adenomatoid malformation (CCAM) of lung. Ultrasound showed the intrathoracic mass as a hyperechoic lesion and the feeding artery could be found by Doppler ultrasonography. T2WI could reveal not only the hyperintense lesions with clear boundary, but also the hypointense feeding artery originating from systemic circulation. Compared with pathological examination or enhanced CT, both of the ultrasound and the MRI could locate the lesions;however 2 feeding arteries were misjudged. Conclusions Prenatal ultrasound is the first-choice diagnostic modality for BPS. MRI can demonstrate the location, morphology and the feeding arteries of the fetal BPS, and also estimate the volume of normal lungs, which could be an important supplement to prenatal ultrasound in prenatal diagnosis and prognostic prediction of BPS.

Objective To discuss the value of prenatal ultrasound and MRI in diagnosis of fetal agenesis of corpus callosum (ACC). Methods Sixty-seven fetuses from Hubei Maternal and Children's Hospital performed fetal MRI from July 2013 to December 2014 were included in this study. All fetuses (67 cases) with suspected ACC were studied with a 1.5T MR unit within 3 days after ultrasound examination. Prenatal ultrasound and MRI findings were studied. Results All the 67 ACCs previously suspected on ultrasound were confirmed by MRI. Among the 67 ACCs, 58 cases were complete ACC and 9 cases were partial ACC. Corpus callosum body and/or splenium absence was found in all 9 partial ACC cases. In all cases, on MRI, corpus callosum complete or partial absence was showed on the median sagittal images, and mild to moderate ventriculomegaly and abnormal morphology in lateral ventricle was shown on the axial or coronary images. Conclusions MRI has high value in diagnosis of ACC. When ACC is found or suspected by ultrasonophy, MRI examination is suggested to confirm the diagnosis.

ObjectiveTo explore the imaging features of fetal tuberous sclerosis complex by ultrasonography and magnetic resonance imaging.MethodsRetrospective analysis on the imaging characteristics of the 10 cases of fetuses confirmed as tuberous sclerosis complex who were examined in Hubei Maternal and Child Healthcare Hospital in July 2013 to December 2014 by ultrasonography and MRI, which was compared with the pathological data of specimens and follow-up after birth.ResultsEighteen cases were diagnosed as fetal cardiac rhabdomyoma by ultrasonography among all of the 996 fetuses, in which lesions were located on the ventricular wall near septum or elsewhere in the heart cavity on ultrasonography. Fetal cardiac rhabdomyoma was characterized by circular, homogeneous high echo (singleton in 4 cases, multiple in 14 cases). Among them no subependymal nodule was found by ultrasonographic. Ten cases of subependymal nodule were found by magnetic resonance imaging, which were diagnosed as tuberous sclerosis complex with cardiac rhabdomyomas, including 3 cases of brain subcortical tubers. The subependymal nodules under the lateral ventricle wall showed characteristic low signal nodules on T2WI, protruding from the ependymal surface. Of 18 cases, only 4 cases of fetal cardiac rhabdomyoma were found by MRI. Nine cases of ifnally had termination of pregnancy. Two cases were conifrmed as cardiac rhabdomyoma with intracranial nodules after pathological examination, and 1 case was conifrmed as tuberous sclerosis complex after birth. ConclusionsPrenatal ultrasonography can diagnose fetal cardiac rhabdomyoma successfully, and MRI can diagnose the fetal brain nodules sensitively. Once ultrasonography finds cardiac rhabdomyoma, it may be promising to diagnose fetal tuberous sclerosis complex by ultrasonography combined with MRI.

Objective To evaluate the effect of kojic acid( KA) on the immune system of mice after exposure to gam-ma-irradiation.Methods Twenty male C57BL/6 mice were divided into normal group, irradiation group, low/high doses of KA pretreated groups.Mice in normal group did not receive any treatment,while mice in other groups were sc injected with a single dose of sterile distilled water or KA(75 and 300 mg/kg, respectively) 27 h prior to a sublethal dose(4 Gy, 138.54 and 140.30 cGy/min, respectively) of whole body gamma-irradiation.The injected volume was calculated by 0.2 ml/20 g.Forty mice were sacrificed at day 2 and day 8 post-irradiation, respectively.The splenic lymphocyte transformation and spleen and thymus indexes were determined.Histopathological sections were produced, and the morphological changes were also observed.Results The splenic lymphocyte transformation capacity and spleen and thymus indexes of mice pre-treated with 300 mg/kg elatve mass KA were increased significantly ( P<0.01) compared with the irradiation group.The morphological changes in the spleen and thymus of mice in 300 mg/kg KA pretreated group were better than in the irradia-tion group.The above parameters of mice in irradiation group were injured severely in comparison with the normal group. Conclusion Acute radiation can damage the immune system of mice obviously.KA can enhance the transformation capaci-ty of lymphocytes and has marked protective effect on the immune system of mice after irradiation.