最新刊期
卷 49 ， 期 3 ， 2024
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Evolution and considerations of diagnostic criteria for neonatal acute respiratory distress syndrome AI导读
摘要：Since acute respiratory distress syndrome (ARDS) was firstly reported in 1967, the diagnostic criteria and classification standard have evolved continually. Neonatal ARDS has drawn increasing attention in recent years, while research on neonatal ARDS has proceeded slowly, partly because of ambiguity in the definitions and diagnostic criteria of neonatal ARDS. In this comment, we overview the application of the Berlin definition made in 2012, the Montreux definition made in 2017, and the definition of pediatric ARDS update by the Second Pediatric Acute Lung Injury Consensus Conference made in 2023 (PALICC-2 definition) in neonatal ARDS, then compare the similarities and differences among the three definitions. Finally, the differences in classification standard, triggers, morbidity, mortality, poor prognosis, and treatment among the three definitions for neonatal ARDS were analyzed, and the research directions in the future of the definition for neonatal ARDS were proposed.关键词：neonatal acute respiratory distress syndrome;diagnostic criteria;changes- 6
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发布时间：2024-04-07 -
摘要：According to the extracorporeal life support (ECLS) registry report, the use of extracorporeal membrane oxygenation (ECMO) in neonates with severe respiratory failure reached its peak in 1992. With the emergence of new respiratory support methods such as nitric oxide, pulmonary surfactant, and high-frequency ventilation, the number of neonates with ECMO for respiratory support decreased gradually, maintaining at about 1000 cases per year. However, it also means that the neonates who need ECMO support will be in a more severe condition, which requires higher requirements for clinicians. In order to further standardize the technique of neonatal extracorporeal life support, the Extracorporeal Life Support Organization (ELSO) published the guidelines for neonatal respiratory failure in 2020. The guidelines provide suggestions on the technology, patient management and complications during ECMO. This article mainly interprets the patient selection, support mode, technical considerations, management and complications during ECMO.关键词：extracorporeal membrane oxygenation;neonate;respiratory failure- 16
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发布时间：2024-04-07 - 摘要：ObjectiveTo explore the role of pulmonary surfactant (PS) combined with budesonide in improving oxygenation and clinical outcomes of neonatal acute respiratory distress syndrome (ARDS).MethodsThe present study is a historically controlled trial. Infants with ARDS requiring mechanical ventilation and PS replacement therapy were collected from the neonatal unit of Southwest Medical University. Those from January 2022 to November 2022 were set as intervention group (PS+budesonid, n=35), treated with intratracheal instillation of a mixed suspension of budesonide (0.25 mg/kg) and PS (200 mg/kg), and continuous budesonide nebulization (0.25 mg/kg, twice per day) until withdrawal, then compared with a historical cohort, who just received intratracheal instillation of PS (200 mg/kg) (January 2020-December 2021, PS group, n=35). Baseline data such as gender, mode of delivery, 1 min and 5 min Apgar score, birth weight, gestational age, time of onset, and cause of onset were recorded in both groups. The oxygenation and clinical outcomes of infants were compared between the two groups, including: (1) Arterial blood gas analysis indicators, such as partial pressure of oxygen (PaO2) and oxygenation index (OI) before treatment and at 6, 12 and 24 hours of treatment; (2) Clinical observation and evaluation indicators, such as the time to withdrawal, duration of oxygen supplementation, length of stay, improvement of the radiological images of the lungs at 72 h of treatment, and repeated PS use; (3) Blood chemistry indicators, such as white blood cell (WBC), neutrocyte (NEU), procalcitonin (PCT) before treatment and at 3 and 7 days of treatment; and (4) Observation indicators of complications, weight growth, and mortality outcomes, such as the incidences of intracranial hemorrhage, gastrointestinal hemorrhage, neonatal necrotizing enterocolitis (NEC), and hyperglycemia, weight growth, and fatality rate.ResultsThe differences in baseline data between the two groups were not statistically different (P>0.05). The levels of PaO2 of the two groups were increased after treatment for different time periods, while the levels of OI were decreased (P<0.001), and the levels of above indexes changed more significantly in PS+budesonide group than those in PS group (P<0.05). The time to withdrawal, duration of oxygen supplementation, and length of stay in PS+budesonide group were shorter than those in PS group; the radiological images of the lungs showed that the pulmonary inflammation absorption was significantly better in PS+budesonide group than that in PS group, while no significant difference between the two groups of infants with repeated PS use. The NEU was significantly higher in PS+budesonide group than in PS group at 3 d and 7 d of treatment (P<0.001); and at 3 days of treatment, the PCT levels were significantly lower in PS+budesonide group than that in PS group (P<0.05). The incidences of intracranial hemorrhage, gastrointestinal hemorrhage, NEC, hyperglycemia, weight growth, and fatality rate were not significantly different between the two groups (P>0.05).ConclusionThe use of budesonide in addition to surfactant may improve the oxygenation of neonates with ARDS, improve the inflammatory infiltrates in lungs, shorten the duration of mechanical ventilation and oxygen supplementation, and without short-term complications associated with budesonide use.关键词：pulmonary surfactant;budesonide;acute respiratory distress syndrome;neonate
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发布时间：2024-04-07 -
摘要：ObjectiveTo investigate the role of dynamin-related protein 1 (Drp-1) and peroxisome proliferator-activated receptor γ coactivator 1-α (PGC-1α) in the lung tissues of neonatal rats with meconium aspiration syndrome (MAS) and its mechanism.MethodsFifty 2-3-week-old SD neonatal rats were randomly divided into five groups (n=10): control group, model group and SN50 low, medium and high concentration groups. In control group, 2 ml/kg of saline was injected into the trachea after tracheal exposure, and 2 ml/kg of meconium suspension was injected into the trachea of the rest of groups; after 24 h, control and model groups were left untreated, and 100 μl of each of SN50 concentrations of 10, 30, and 60 μg/ml was injected into SN50 low, medium, and high concentration groups intraperitoneally; the rats of each group were killed after 6 h, and the chest X-rays, the gross views of the lungs, the lung wet/dry weight ratios (W/D), and the lungs of the rats in control group and model group were examined. After 6 h, the rats in each group were executed, and the pathological changes of lung tissue were observed by chest radiographs, lung gross view, lung wet/dry weight ratio (W/D) and HE staining; Western blotting was used to detect the changes of nuclear factor κB (NF‑κB) (p65), p-NF‑κB p65 (p-p65), Drp-1, and PGC-1α proteins expression in neonatal rat lung tissues, and immuno-histochemistry was used to observe the expression of p65, Drp-1, and PGC-1α related proteins expression in neonatal rat lung tissues.ResultsCompared with control group, model group showed inflammatory infiltration in the chest radiograph and gross view, and the W/D and lung injury pathology scores were significantly higher (P<0.05); compared with model group, the chest radiograph and gross view of inflammation were slightly reduced in SN50 low, medium and high concentration groups, and the W/D and lung injury pathology scores were significantly lower (P<0.05).Western blotting showed that, compared with control group, the protein expression levels of p-p65 and Drp-1 in the lung tissues of neonatal rats were significantly higher in model group (P<0.05), and the protein expression level of PGC-1α was significantly lower (P<0.05); compared with model group, the protein expression levels ofp-p65 and Drp-1 were significantly lower in SN50 low, medium, and high concentration groups (P<0.05), and the difference in the protein expression level of PGC-1α in SN50 low concentration group was not statistically significant (P>0.05), whereas the PGC-1α expression levels in SN50 medium and high concentration groups were significantly higher (P<0.05); the difference in the total p65 protein expression levels in each group was not statistically significant (P>0.05). Immunohistochemical assay results showed that, compared with control group, p65 and Drp-1 protein expression levels were significantly higher in model group (P<0.05), and PGC-1α protein expression level was significantly lower (P<0.05); compared with model group, p65 protein expression level was significantly lower in SN50 low concentration group (P<0.05), and the difference in Drp-1 and PGC-1α protein expression levels were not statistically significant (P>0.05), Drp-1 protein expression level was significantly lower (P<0.05), and PGC-1α protein expression level was significantly higher (P<0.05) in SN50 middle and high concentration groups.ConclusionFecal inhalation can induce lung tissue inflammation in neonatal rats, and the mechanism may be related to enhanced oxidative stress, promotion of mitochondrial dysfunction, activation of the Drp-1/NF-κB signaling pathway, and inhibition of PGC-1α protein expression.关键词：meconium aspiration syndrome;nuclear factor κB;oxidative stress;mitochondria- 9
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发布时间：2024-04-07
Special Issue of Diagnosis and Treatment of Neonatal Respiratory Distress Syndrome
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摘要：ObjectiveTo analyze the burden and changing trend of testicular cancer in China from 1990 to 2019. MethodsBased on the 2019 Global Burden of Disease Database (GBD 2019), analyze the incidence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), years lived with disability (YLDs) and their variation trend of testicular cancer in Chinese population from 1990 to 2019. Evaluating changes in age standardized rate (ASR) by calculating annual estimated percentage change (EAPC). According to the age grouping, analyze the age distribution characteristics of testicular cancer disease burden by age group.ResultsIn 2019, the incident cases, deaths, age-standardized incidence rate, and age-standardized mortality rate of testicular cancer in China were 17.17×103, 1.21×103, 2.39/105, and 0.16/105, respectively. Compared to 1990, incident cases, deaths, and age-standardized incidence rate increased obviously in China, which was consistent with the global change trend, while the increase was higher than the global level. However, both Chinese and global age-standardized mortality rate showed a downward trend. From 1990 to 2019, DALYs, YLLs and YLDs of testicular cancer increased by 29.66%, 9.83% and 720.91% respectively in China. The two age groups, 0-15 years group and 30-35 years group, were with highest incidence of testicular cancer, while the highest disease burden of testicular cancer was 30-35 years.ConclusionFrom 1990 to 2019, the disease burden of testicular cancer in China showed an upward trend. Adolescents and young adults should be the priority population for screening and prevention due to their higher incidence and disease burden.关键词：testicular cancer;disease burden;incidence;mortality;disability-adjusted life years- 12
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发布时间：2024-04-07 -
摘要：ObjectiveTo analyze the pathogenic characteristics and drug sensitivity of candidaemia, and construct a short-term mortality risk prediction scoring model.MethodsThe clinical data of patients with candidaemia admitted to the 909 Hospital of Joint Logistics Support Force from January 2011 to December 2020 were retrospectively analyzed, and the composition of pathogen composition, drug sensitivity test results and incidence of hospitalized patients were analyzed. 324 cases of candidaemia were randomly divided into modeling group (190 cases) and validation group (134 cases), and the risk factors were screened by binary logistic regression. According to the odds ratio (OR) score, the 30 day mortality risk prediction scoring model was constructed, and the predictive performance of the model was verified both in modeling and validation groups.Results356 strains of Candida including 126 strains of C. albicans (35.39%), 79 strains of C. tropicalis (22.19%), 74 strains of C. parapsilosis (20.79%), 48 strains of C. glabrata (13.48%), 14 strains of C. guilliermondii (3.93%), 8 strains of C. krusei (2.25%), and 7 strains of other Candida (1.97%) were detected in 336 patients with candidemia. The incidence of candidaemia among hospitalized patients increased from 0.20 ‰ in 2011 to 0.48 ‰ in 2020. The resistance rate of candida to amphotericin B was significantly lower than that of fluconazole, voriconazole and itraconazole (P<0.05). Among the 324 cases included in the model, 95 patients died in 30 days after diagnosis, and the mortality rate was 29.32%. The proportion of males, fever, and parenteral nutrition in modeling group was significantly higher than that in validation group (P<0.05), while the proportion of chronic lung disease and surgical history within one month were lower than those in validation group (P<0.05). Logistic regression analysis showed that chronic renal failure, mechanical ventilation, severe neutropenia, failure to receive anti-fungal treatment within 72 hours, and APACHE Ⅱ ≥20 were risk factors for short-term death of candidaemia, the OR values were 3.179, 1.970, 2.979, 2.080, and 2.399, and the risk scores were 6, 4, 6, 4, and 5, respectively. The area under the curve (AUC) of the risk scoring model for modeling group was 0.792 (95%CI 0.721-0.862), and the result of Hosmer-Lemeshow (H-L) test was P=0.305; The AUC of validation group was 0.796 (95%CI 0.735-0.898), and the H-L test result was P=0.329. A risk score≤8 indicated a low risk group for short-term mortality, a score of 9-15 indicated a medium risk group, and a score ≥16 indicated a high risk group.ConclusionsThe incidence of candidemia in hospitalized patients is increasing and the mortality is high. The risk prediction score model can effectively predict the short-term prognosis and facilitate the early identification of the prognosis.关键词：candidaemia;drug sensitivity test;risk factors;prediction;scoring model- 10
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发布时间：2024-04-07 -
摘要：ObjectiveTo investigate the role of pulmonary neuroendocrine cells (PNEC) and γ‑aminobutyric acid (GABA) in patients with pulmonary neuroendocrine tumors (PNET).MethodsThe pathological specimens of 29 cases of PNET treated in the eighth Medical Center of Chinese PLA General Hospital from October 2018 to January 2022 were collected. The morphological characteristics were observed by HE staining, and the expression levels of synaptophysin (Syn), chromogranin A (CgA), CD56, Ki-67, CD86 and CD163 were observed by immunohistochemical staining. Calcitonin gene-related peptide (CGRP) and glutamic acid decarboxylase (GAD) 65/67 in different types of PNETs were detected by double antibody immunofluorescence co-staining, and the correlation between GAD65/67 positive PNEC and macrophage polarization was analyzed.ResultsThe results of HE staining showed that all four types of PNET tissues had neuroendocrine (NE) characteristics: rosette structure and organ nesting or palisade pattern, but they were different, and the proportion of mitotic cells from low to high was typical carcinoid (TC), atypical carcinoid (AC), large cell neuroendocrine carcinoma (LCNEC) and small cell lung cancer (SCLC). The results of immunohistochemical staining showed that the positive expression rate of Syn and CgA and the positive degree of Syn, CgA and CD56 in carcinoid (TC and AC) were significantly higher than those in LCNEC and SCLC (P<0.05). The Ki-67 indices of the four types of PNET are: TC <5%, AC 5%-20%, LCNEC and SCLC >75% respectively. The number of PNEC in carcinoid was significantly higher than that in LCNEC, SCLC and paratumoral tissues (P<0.05), but there was no significant difference in the number of PNEC between LCNEC and SCLC and para-tumor tissues (P>0.05). The results of immunofluorescence staining showed that the number of GAD65/67 positive cells co-expressing GAD65/67 in 95%PNEC was significantly higher than that in LCNEC, SCLC and para-tumor tissues (P<0.05), but there was no significant difference between LCNEC and SCLC GAD65/67 positive cells and para-tumor tissues (P>0.05). The results of immunohistochemical staining also showed that the number of CD86 positive M1 macrophages was significantly higher than that of CD163 positive M2 macrophages in para-tumor tissues (P<0.05), while M2 macrophages were significantly more than M1 macrophages in AC, LCNEC and SCLC (P<0.01). Correlation analysis showed that the number of GAD65/67 positive PNEC cells in PNET was negatively correlated with the number of CD163 positive M2 macrophages in tumor stroma (r=-0.6336, P=0.0174).ConclusionsPNEC is the main source of GABA in lung tissue and plays an immunomodulatory role in the lung, which may be involved in the progression of PNET.关键词：pulmonary neuroendocrine cell;γ-aminobutyric acid;macrophage;pulmonary neuroendocrine tumor- 8
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发布时间：2024-04-07 - 摘要：ObjectiveTo analyze the risk factors for severe illness caused by coronavirus disease 2019 in Fuzhou city.MethodsThe data of 4081 confirmed cases with current address in Fuzhou was collected from China Information System for Disease Control and Prevention from January 1 to June 30, 2023. The epidemiological data of those cases was investigated such as the demographic characteristics, clinical manifestations and past medical history, etc. The risk factors of severe cases were analyzed by using the logistic regression.Results4081 confirmed cases had been reported including 671 severe cases and 3410 non-severe cases. The demographic characteristics of severe cases, such as the proportion of male, age and current address in community were higher than that of non-severe cases, vaccination rate was lower than non-severe cases (59.02% vs. 80.12%), the differences are statistically significant (P<0.001). The clinical manifestations such as interval time between onset and visit (P=0.001), fever (P=0.002), difficulty in breathing/shortness of breath (P=0.001) were the factors related to severe illness. The past medical histories such as history of chronic lung disease, history of heart cerebrovascular disease of severe cases, were higher than that of non-severe cases (P<0.001). Multivariate logistic regression showed that the male, the higher age, current address in community, no vaccination, the longer interval time between onset and visit, fever, difficulty in breathing/shortness of breath, the history of chronic lung disease, the history of heart cerebrovascular disease raised the risk of becoming severe cases. The healing time for severe cases was longer than that for non-severe cases (P<0.001).ConclusionSex, age, current address, vaccination, interval time between onset and visit, fever, difficulty in breathing/shortness of breath, history of chronic lung disease, and history of heart cerebrovascular disease are the influencing factors for severe illness.关键词：coronavirus disease 2019;severe case;risk factor
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发布时间：2024-04-07 -
摘要：ObjectiveTo evaluate the efficacy of surgery, chemotherapy and surgery combined chemotherapy for retinoblastoma (RB), and analyze the prognostic factors of RB patients.MethodsClinical data of 1188 RB patients registered in the Surveillance, Epidemiology and End Results (SEER) database from January 2000 to December 2019 were retrospectively analyzed. The baseline characteristics of patients treated with surgery, chemotherapy or surgery combined with chemotherapy were balanced by inverse probability of treatment weighting (IPTW). Log-rank test analysis was used to compare the survival probability of patients in the 3 groups, and Cox regression models were used to analyse the factors influencing the prognosis of RB patients.ResultsA total of 1188 RB cases were included in this study, including 426 cases in surgery group, 200 cases in chemotherapy group and 562 cases in surgery combined with chemotherapy group. After IPTW weighting, baseline data such as age, sex and race were balanced (P>0.05). Log-rank test results showed that the survival curves of the three groups were significantly different before and after weighting(P<0.05). After weighted, the survival of patients in surgery group was significantly better than that in chemotherapy group and surgery combined chemotherapy group (P<0.05), and there was no statistical significance between chemotherapy group and surgery combined chemotherapy group (P>0.05).The weighted patient survival probability at 1st, 3rd and 5th years were 99.7%, 98.9% and 98.6% in surgery group; 97.4%, 95.8% and 95.8% in chemotherapy group; and 97.9%, 95.8% and 95.0% in surgery combined chemotherapy group. Cox regression analysis showed that compared with surgery group, the specific risk ratio of death was 1.367 (95%CI 1.100-1.700) in chemotherapy group and 1.132 (95%CI 0.963-1.330) in combined chemotherapy group. Compared with patients with 1 RB lesion, the patient-specific mortality risk ratio for patients with 2 or more RB lesions was 0.399 (95%CI 0.268-0.594).ConclusionsPatients with RB have higher survival rates probability after treatment. After controlling the influence of age, sex and other factors, the effect of surgery was better among the three treatment methods. Multifocality may be an independent prognostic factor in RB patients.关键词：retinoblastoma;inverse probability of treatment weighting;efficacy;survival analysis- 10
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发布时间：2024-04-07 -
Differential diagnosis of adult-onset Still's disease with other fever of unknown origin causes AI导读
摘要：ObjectiveTo explore the differential diagnostic indicators of adult-onset Still's disease (AOSD) from other fever of unknown origin (FUO).MethodsThe clinical data and laboratory indicators of 177 AOSD patients and 163 FUO patients who were hospitalized in the First Affiliated Hospital of Army Medical University from January 2010 to May 2021 were collected, and the patients were randomly divided into training group and verification group. Statistically significant variables were extracted from univariate analysis for receiver operating characteristic (ROC) curve analysis and the best cut-off value of the variables was obtained. The differential diagnostic indicators were extracted by multivariate logistic regression analysis and nomogram model was constructed. ROC curve, calibration curve, and decision curve analysis were used to evaluate the accuracy and stability of nomogram.ResultsUnivariate analysis revealed that there were significant differences in 4 clinical features (arthralgia, rash, pharyngeal pain, myalgia) and 14 laboratory parameters [white blood cell count (WBC), monocyte percentage, neutrophil percentage, lymphocyte percentage, platelet count, C-reactive protein, interleukin-6 (IL-6), ferritin, globulin, immunoglobulin A, and immunoglobulin G (IgG), creatine kinase, creatinine and complement C3]. Multivariate analysis suggested that arthralgia, WBC ≥9.995×109/L, IL-6 ≥98.13 ng/L, ferritin ≥507.37 ng/ml, globulin ≤36.58g/L, IgG ≤13.59g/L, complement C3 ≥1.27 g/L were related with AOSD. The area under curve (AUC) values of training group and verification group were 0.917 (95%CI 0.883-0.951) and 0.869 (95%CI 0.802-0.936), respectively. The calibration curves showed good consistency. The decision curve analysis showed that training group and verification group had a large positive rate of return in the wide risk range of 5%-85% and 10%-85%, respectively.ConclusionsThis study has established a relatively accurate AOSD differential diagnosis model. The combination of arthralgia, WBC, IL-6, ferritin, globulin, IgG and complement C3 may help to distinguish AOSD from other causes of FUO.关键词：adult-onset Still's disease;fever-of-unknown-origin-etiology;differential diagnosis- 6
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发布时间：2024-04-07
Clinical Research
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摘要：ObjectiveTo observe the effects of total saponins of Trillium tschonoskii Maxim (TST) on vascular cognitive impairment (VCI), neurovascular units (NVUs), and neural circuit integrity in rats.MethodsForty-eight male Sprague-Dawley (SD) rats were randomly divided into sham-operated group, model group, TST group (intragastric administration, 100 mg/kg), and donepezil group (intragastric administration, 0.45 mg/kg), and then subjected to ischemic stroke by 2-VO method (bilateral common carotid artery ligation) or sham surgery. After 28 days of intragastric administration, Mirros water maze test was performed to evaluate the spatial learning and memory abilities of rats in each group. HE and Nissl staining were used to observe the pathological changes of brain tissue in rats. The expression of synuclein (SYN) in rat hippocampus was observed by immunohistochemical staining. Changes in dendritic spines in rat's hippocampal neurons were observed by Golgi staining. Western blotting was used to detect the expression levels of IL-1β, IL-10, vascular endothelial growth factor A (VEGFA), postsynaptic density protein 95 (PSD95), and growth associated protein 43 (GAP43) in rat's hippocampus in each group.ResultsIn Mirros water maze test, rats in model group showed significant prolonged escape latency (P<0.05), and a significant reduction in the number of crossing platforms and the percentage of activity time in the target quadrant (P<0.05) than those in sham-operated group; while rats in TST group and donepezil group showed significant shortened escape latency (P<0.01), and significant increase of the number of times of crossing platforms and the percentage of activity time in the target quadrant (P<0.05) than those in model group. Compared of sham-operated group, model group showed a decrease in the expression of SYN and the number of neurons, Nissl bodies, and dendritic spines in the CA1 region of the hippocampus (P<0.05). Compared with model group, TST group and donepezil group showed an increase in the expression of SYN and the number of neurons, Nissl bodies, and dendritic spines in the CA1 region of the hippocampus (P<0.05). Western blotting showed a significant increase in the expression of IL-1β and VEGF (P<0.05), and a decrease in the expression of IL-10, PSD95, and GAP43 (P<0.01) in rat's hippocampus of model group than those in sham-operated group. Compared with model group, TST group and donepezil group showed a significant decrease in the expression of IL-1β (P<0.05), and an increase in the expression of VEGFA, IL-10, and GAP43 (P<0.05).ConclusionsTST could alleviate cognitive impairment through promoting synaptic plasticity and neurovascular unit remodeling in 2-VO model rats, suggesting its significance as a potential drug for apoplexy.关键词：total saponins of Trillium tschonoskii Maxim;2-VO;cognitive function;neurovascular unit;apoplexy- 6
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发布时间：2024-04-07 -
Effect and mechanism of radiation combined with different decompression loads on acute injury of rat AI导读
摘要：ObjectiveTo investigate the effect of rats' injuries and its mechanism caused by specific dose of radiation combined with decompression exposure.Methods81 male SD rats were randomly divided into control group (n=9), radiation group(n=18), radiation+low-load decompression group (n=18), radiation+medium-load decompression group (n=18), and radiation+high-load decompression group (n=18). In addition to control group, the rats were irradiated with 60Co γ rays at 4 Gy and then underwent rapid escape experiments. The high-pressure exposure schemes were to stay underwater 57 m for 30 min, 45 min or 60 min and reduce to normal pressure within (30±5) s, respectively. The high-pressure exposure was not carried out in radiation group. The behavior and death of rats in each group were observed 0.5 h after leaving the cabin. Blood (abdominal aorta) and lung tissues were collected at 3 h and 72 h, respectively. The changes of lung wet-dry weight ratio (W/D), lung pathology and serum levels of interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), intercellular adhesion molecule-1 (ICAM-1) and thromboxane B2 (TXB2) were analyzed.ResultsCompared with control group and radiation group, radiation+low-load decompression group showed no significant difference in the injury and death rate of rats (P>0.05), while radiation+medium-load decompression group and radiation+high-load decompression group showed significantly increase of the injury and death rate of rats (P<0.05). Compared with control group, other groups showed no significant change in pulmonary W/D at 3 h (P>0.05), and increased at 72 h (P<0.05). HE staining showed that compared with control group, radiation group showed mild lung interstitial edema, while radiation+low-load decompression group showed obvious pulmonary tissue edema and a small number of red blood cells exudated in the alveolar cavity. The edema, congestion and inflammatory cell infiltration of lung tissue were more serious in radiation+medium-load decompression group and radiation+high-load decompression group. Compared with control group and radiation group, all radiation+decompression groups showed an increase in serum levels of IL-1β, IL-6, TNF-α, MDA, NO, ICAM-1 and TXB2 (P<0.05), and a decrease in SOD activity (P<0.05). Compared with radiation+low-load decompression group, radiation+medium-load decompression group and radiation+high-load decompression group showed increase in serum levels of IL-1β, IL-6, MDA, ICAM-1 and TXB2 (P<0.05), and decrease in activity of SOD (P<0.05). Except for control group, serum levels of IL-1β, IL-6, TNF-α, MDA, NO, ICAM-1 and TXB2 were decreased at 72 h compared with 3 h (P<0.05), and SOD activity was increased at 72 h in all groups (P<0.05).ConclusionsHigh-load decompression can increase the injury and death rate of rats exposed to radiation and high pressure. The potential mechanism of the combined injury effect of radiation and decompression was related to inflammation, immune stress, oxidative damage, vasomotor activity and coagulation mechanism.关键词：radiation injury;decompression sickness;combined injury;rat;effect- 8
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发布时间：2024-04-07
Basic Research
- 摘要：The progress and clinical application of troponin detection technology have continuously improved the diagnosis rate of acute myocardial infarction (AMI), which effectively shortens the time of necrotic myocardial reperfusion. Earlier studies have found that high-sensitivity troponin (hs-cTn) is elevated to varying degrees in patients with chronic kidney disease (CKD). Therefore, when patients with CKD have AMI, the application of hs-cTn is limited to a certain extent, and with the lack of chest pain symptoms and the non-specificity of electrocardiogram performance in patients with CKD, it is particularly difficult to make a quick and accurate diagnosis of such patients. Based on this, this article will summarize the application of hs-cTn in AMI, the clinical characteristics of patients with CKD combined with AMI, how to improve the diagnostic accuracy of patients with CKD combined with AMI, and the value of hs-cTn in risk stratification and prognosis assessment of such patients to provide clinical medical staff with reference for early intervention or revascularization of patients.关键词：high-sensitivity troponin;Acute myocardial infarction;chronic kidney disease
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发布时间：2024-04-07 - 摘要：In recent years, with the continuous innovation of modern war mode, weapons and protective equipment, the mechanism and mode of war trauma have also produced great changes. The widespread use of bulletproof vest and improvised explosive devices has led to increasing incidence of genitourinary trauma. The pattern of genitourinary trauma has also transformed from internal structures (kidney, ureters, bladder) to external structures (scrotum, testes, penis, urethra), suggesting that the research focus of genitourinary system war trauma should be gradually transformed to trauma research of lower urinary tract and external genitalia. This article reviews the incidence, treatment and prognosis of genitourinary trauma in several modern wars, and mainly describes the relevant conditions of lower urinary tract and external genitalia trauma and the relevant progress in the treatment in recent years.关键词：genitourinary injury;lower urinary tract;external genitalia;war injury;diagnosis and treatment
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发布时间：2024-04-07 - 摘要：α7 nicotinic acetylcholine receptor (α7nAChR) is widely expressed in the central nervous system and immune system, and plays a neuro-immunoregulatory role. On the one hand, α7nAChR is involved in the transmission of neurotransmitters, the conduction of excitatory signals and the maintenance of synaptic plasticity, which is of great significance for maintaining the normal and stable neurocognitive function. On the other hand, as an important part of the cholinergic anti-inflammatory pathway, α7nAChR is involved in the regulation of physiological and pathological processes such as inflammatory response, oxidative stress, apoptosis and autophagy in the central system, and plays an immunomodulatory and neuroprotective role, thus being potential target for improving perioperative neurocognitive function. This article reviews the biological characteristics of α7nAChR and its effect on perioperative neurocognitive function, in order to provide ideas and methods for clinical improvement of perioperative neurocognitive function in surgical patients.关键词：α7 nicotinic acetylcholine receptor;perioperative period;neurocognitive function;cholinergic anti-inflammatory pathway
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发布时间：2024-04-07 -
摘要：Unilateral biportal endoscopic (UBE) technique is a minimally invasive spinal technique developed rapidly in recent years. Compared with traditional spinal endoscopy, the prominent feature of UBE is that it can open two channels on the same side of the spine, which can be used to provide visual field and insert operating instruments respectively, greatly expanding the operating space and reducing the difficulty of surgery. It has the advantages of less bleeding, little injury, quick recovery and mild pain, and has unique advantages in the treatment of lumbar spinal stenosis, lumbar disc herniation and other lumbar degenerative diseases. With the continuous in-depth exploration and development of the UBE technique, the field of diseases that can be treated by this technology has gradually expanded. It is not only limited to lumbar diseases, but also has made great progress in cervical and thoracic diseases, which has attracted the attention of many spinal surgeons. UBE technique has become one of the promising surgical methods for spinal-related diseases, but there are also complications such as incomplete decompression, nerve root and dural injury, epidural hematoma, relatively prolonged operation time, operation fatigue and other deficiencies. This paper summarizes the progress of the UBE technique, discusses its complications and deficiencies, proposes relevant solutions and possible future directions for its development, so as to provide reference for the clinical practice of UBE technique.关键词：unilateral biportal endoscopic technique;minimally invasive spine technology;lumbar spinal stenosis;lumbar disc herniation;lumbar spondylolisthesis- 10
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发布时间：2024-04-07 -
摘要：The essence of cirrhosis is the over-repairing reaction of liver tissue damage in the process of chronic liver disease. During repair, the liver parenchyma is gradually replaced by fibrosis tissue, resulting in changes in liver tissue morphology, followed by portal hypertension and other related manifestations. Liver failure are serious disorder of liver functions (synthesis, metabolism, transformation, regeneration, etc.) caused by various factors, often mainly manifested as jaundice, coagulation disfunction, hepatic encephalopathy, ascites, etc. The naming and typing of the two are different, and they can exist independently of each other or intersect with each other. In recent years, with the in-depth exploration of cirrhosis and liver failure, many new definitions and classification methods have been put forward in the research. However, due to the confusion of classification methods, there is still a lack of summary, so this article briefly reviews the current progress of clinical classification of liver cirrhosis and liver failure and their differences and intersections.关键词：cirrhosis;liver failure;decompensated;classification- 7
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发布时间：2024-04-07 - 摘要：Sonogenetics is an emerging synthetic biology technique that uses sound waves to activate mechanosensitive ion channel proteins on the cell surface to regulate cell behavior and function. Due to the widespread presence of mechanically sensitive ion channel systems in cells and the advantages of non-invasion, strong penetrability, high safety and high accuracy of sonogenetics technology, it has great development potential in basic biomedical research and clinical applications, especially in neuronal regulation, tumor mechanism research, sonodynamic therapy and hearing impairment. This review discusses the basic principles of sonogenetics, the development status of sonogenetics and its application in the prevention and treatment of noise-induced hearing loss, summarizes and analyzes the current challenges and future development direction, thus providing a reference for further research and development of sonogenetics in the field of military medicine.关键词：sonogenetics;synthetic biology;mechanosensitive ion channels;ultrasonic response;military medicine
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发布时间：2024-04-07
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