Research progress of extracellular matrix in age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

Age-related macular degeneration(ARMD)is the leading cause of blindness in the elderly. Studies have shown that the regulation disorder of extracellular matrix(ECM)is one of the important characteristics of ARMD, and its damage can be sustained throughout the disease course. Additionally, various cell types participate in the formation and abnormal deposition of ECM under the control of multiple signals. Subsequently, they transmit signals that regulate adhesion, migration, proliferation, apoptosis, survival or differentiation, which lead to the destruction of the retinal and choroidal microenvironment, immune dysfunction, infiltrative inflammatory cell differentiation, neovascularization and epithelial mesenchymal transformation, and ultimately lead to subretinal fibrosis, scarring and severe visual impairment in advanced ARMD. Therefore, increasing attention has been paid to the role of ECM in ARMD in recent years. This article reviews the relationship between retinal ECM and ARMD and the role between ECM and various types of cells in ARMD, hoping to provide guidance for the research direction of ARMD treatment.

Changes in related parameters after secondary preparation of blood components / 中国输血杂志

【Objective】 To study the changes in related parameters after secondary preparation of blood components, in order to further improve the quality of blood components. 【Methods】 Different centrifugation conditions were selected for the preparation of primary blood component red blood cells in additive solution leukocytes reduced, and the quality was tested. Then, using the red blood cells in additive solution leukocytes reduced as the initial blood for secondary preparation, and the red blood cells were washed through the Haemonetics ACP 215 device, and the quality was tested. The preparation parameters of blood components were observed, compared and optimized. 【Results】 Under comparable centrifugation effects of different centrifugation conditions, the quality control items, which of primary blood components of red blood cells in additive solution leukocytes reduced and frozen plasma prepared by the separation, such as volume, hemoglobin, hematocrit and residual white blood cells met the relevant national standards. And the quality control items of secondary blood components of washed red blood cells such as the hemoglobin and superalbumin content both met the relevant national standards, while volume exceeded the standard by 7-14 mL, which can be operated to the standard range. In addition, the recovery rate of red blood cells and the clearance rate of plasma protein could reach 75% and 99% respectively. 【Conclusion】 There is a certain correlation between primary and secondary preparation of blood components, but the relevant parameters of secondary preparation of blood components can be flexibly adjusted according to the actual situation to ensure that the quality of prepared blood component products meet the national standards, thus ensuring clinical treatment effect and safety.

Advances in mechanism and regulatory factors of corneal stromal repair / 国际眼科杂志(Guoji Yanke Zazhi)

Corneal stromal is an important structure to maintain corneal transparency. The corneal stroma can be injured by trauma, infection and surgery. Therefore, corneal stromal wound starts repair with phenotype changes in stromal cell, extracellular matrix remodeling and immune cells migration. The corneal scar was the leading cause of blindness worldwide, which can be caused by corneal stromal fibrosis from increased myofibroblasts and deposited extracellular matrix after sever damage. At present, corneal transplantation is the main treatment for corneal scar, which has limited therapeutic effect because of corneal donor shortage, surgical requirements and the risk of postoperative immune rejection. Recently, great progress has been made in the study of control mechanism of corneal stromal wound healing with various molecules, cells and tissues. This paper reviews the repair mechanism of corneal stromal injury and the regulation mechanism of cause of corneal injury, corneal structure and molecule factors towards corneal stromal injury. It aims at providing new ideas for exploring the mechanism of corneal stromal repair and regeneration, which is supposed to help prevent corneal scar clinically.

Application of femoral I.D.E.A.L localization in anterior cruciate ligament reconstruction with single bundle anterior cruciate ligament / 中国骨伤

OBJECTIVE@#To evaluate the effect of femoral I.D.E.A.L localization in single bundle anterior cruciate ligament reconstruction (ACLR).@*METHODS@#From January 2019 to October 2022, 122 patients with anterior cruciate ligament injury were treated with ACLR, including 83 males and 39 females. The age ranged from 23 to 43 years old, with an average of (32.19 ±8.55) years old. The course of disease ranged from 1 week to 6 months. According to the different surgical schemes, the patients were divided into two groups, namely the traditional group, which adopted the over-the-top femoral lateral positioning scheme, including 64 patients. The I.D.E.A.L group adopted the I.D.E.A.L femoral lateral positioning scheme, including 58 patients. The patient has pain and dysfunction of knee joint before operation. MRI of knee joint indicates anterior cruciate ligament injury. The visual analogue scale(VAS), International Knee Documentation Committee(IKDC) scoring system and Lysholm scoring system were used to evaluate the knee joint function of the patient. KT-2000 was used to detect the recovery of knee joint after operation and to count the postoperative complications.@*RESULTS@#The wounds healed well after operation. One hundred and twenty-tow patients were followed up for 15 to 46 months, with an average of (25.45±9.22) months. The knee joint stability of patients after operation was significantly increased. The VAS at 1 day and 1 week after operation of patients in the I.D.E.A.L group was significantly lower than that in the traditional group(P<0.05). The IKDC score and Lysholm score of patients in the I.D.E.A.L group were significantly higher than those in the traditional group(P<0.05). In the traditional group, there were 6 cases of short-term (<1 month) complications and 19 cases of long-term (≥1 month)complicatios. In the I.D.E.A.L group, there were 3 cases of short-term complications and 7cases of long-term complications(P<0.05).@*CONCLUSION@#The single bundle anterior cruciate ligament reconstruction and femoral I.D.E.A.L positioning can achieve better early postoperative effect and reduce early postoperative pain.

Ultrasound-guided continuous fascia iliaca compartment block for perioperative pain management in elderly patients undergoing hip fracture surgery / 中国骨伤

OBJECTIVE@#To study the effect of ultrasound-guided fascia iliaca compartment block on perioperative analgesia and postoperative complications in geriatric patients with hip fractures.@*METHODS@#A total of 127 elderly patients undergoing hip fracture surgery from January 2021 to September 2021 were randomized to receive ultrasound-guided continuous fascia iliaca compartment block(group F) either intravenous analgesia control group(group C). There were 62 cases in group F, including 19 males and 43 females with an average age of (82.4±7.2) years old ranging from 66 to 95 years old, involving 25 femoral neck fractures and 37 femoral intertrochanteric fractures. There were 65 cases in control group, including 18 males and 47 females, with an average age of (81.4±8.7) years old ranging from 65 to 94 years old, involving 29 femoral neck fractures and 36 femoral intertrochanteric fractures. The visual analogue scale(VAS), minimental state examination (MMSE), observer's assessment of alertness/sedation(OAA/S) scale, modified Bromage score, postoperative complications and general conditions during hospitalization in two groups were observed.@*RESULTS@#The resting and exercise VAS at 30 min after block, anesthesia placement and 6, 24 and 48 h after surgery were lower than those in group C(P<0.05). In group F, MMSE scores at 12 h before surgery, and 1, 3 d after surgery and OAA/S scores at 3 d after surgery were higher than those in group C(P<0.05). The incidence of adverse effects and the number requiring additional analgesia were lower than those in group C(P<0.05). Group F had better perioperative analgesia satisfaction and hospital stay than group C(P<0.05). But there was no significant difference regarding Bromage score and 30-day mortality between two group(P>0.05).@*CONCLUSION@#Ultrasound-guided continuous fascia iliacus space block was safe and effective for elderly patients with hip fracture, and could significantly reduce perioperative pain, improve postoperative cognitive function, and reduce postoperative complications, thereby shortening hospital stay and improving the quality of life during hospitalization.

Effect of Sequence of Pulmonary Artery and Vein Transection in Thoracoscopic Lobectomy on Efficacy and Safety of Patients with Non-small Cell Lung Cancer: A Systematic Evaluation / 肿瘤防治研究

Objective To systematically evaluate the effect of sequence of pulmonary artery and vein transection in thoracoscopic lobectomy on the efficacy and safety of patients with non-small cell lung cancer. Methods PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP and CBM databases were searched for the researches on The post-operative efficacy of pulmonary arteriovenous and pulmonary vein resection sequence in thoracoscopic lobectomy for non-small cell lung cancer. The retrieval time is from the database construction to May 2022. Meta-analysis was performed using RevMan 5.4 software. Results Eight articles were included, including 3 randomized controlled studies and 5 cohort studies, with a total of 1810 patients. Meta-analysis results showed that: The operative time (MD=13.34, 95%CI(7.36, 19.32), P < 0.0001) and intraoperative blood loss (MD=45.29, 95%CI(40.24, 50.35), P < 0.0001) in the group with priority pulmonary vein resection were significantly higher than those in the group with priority pulmonary vein resection. The difference was statistically significant. However, the benefits of OS (HR=1.34, 95%CI (1.12, 1.60), P=0.001) and DFS (HR=1.44, 95%CI(1.18, 1.76), P=0.0003) in the group of priority pulmonary vein transection were significantly better than those in the group of priority pulmonary artery transection, with statistically significant differences. Conclusion Priority pulmonary vein transection during thoracoscopic lobectomy effectively improved patients' OS and DFS, resulting in higher survival benefit for patients with non-small cell lung cancer, but intraoperative bleeding and operation time are more than those with priority pulmonary artery transection.

Quality of psychomotility recovery after propofol sedation for painless gastroscopy and colonoscopy / 北京大学学报(医学版)

OBJECTIVE@#To study the effect of propofol used for painless gastroscopy and colonoscopy on psychomotility recovery.@*METHODS@#One hundred adult patients undergoing painless gastroscopy and colonoscopy were recruited, aged 18-72 years, with American Society of Anesthesiologist (ASA) physical status Ⅰ-Ⅱ. According to age, the patients were divided into youth group (20-39 years old, 27 cases), middle age group (40-54 years old, 37 cases), and elder group (55-64 years old, 36 cases). Propofol was continuously infused according to the patients' condition to mantain the bispectal index (BIS) score 55-64. All the patients received psychomotility assesment 30 min before the operations when the discharge criteria were met including number cancellation test, number connection test and board test. The heart rate, blood pressure, saturation of pulse oximetry, electrocardiograph and BIS were monitored during the operation. The operating time, recovery time, total volume of propofol and discharge time were recorded. If the results obtained were inferior to those before operation, a third assessment was taken 30 minutes later until the results recovered or being superior to the baseline levels.@*RESULTS@#All the patients completed the first and second assessments, and 25 patients had taken the third assessment. There was no statistically significant difference in the results of psychomotility assessment when the patients met the discharge standard. Furthermore, the results were analyzed by grouping with age, and there was no statistical difference in the test results of the youth and middle age groups compared with the preoperative group, among which, the efficiency of the number cancellation test was significantly better than that before operation in the youth group (P < 0.05). However, in the elderly patients the number cancellation efficiency, number connection test and board test were significantly inferior to that before operation (P < 0.05). There was no significant difference in the accuracy of number cancellation compared with that before operation. The patients who needed the third test in the elder group were significantly more than in the other groups (P < 0.05). Compared with the preoperative results, there was no statistical difference in the test results of those who completed the third test.@*CONCLUSION@#The psychomotility function of the patients who underwent painless gastroscopy and colonoscopy was recovered when they met discharge criteria. The elderly patients had a prolonged recovery period.

Research progress on the role of macrophages in echinococcosis and the regulation of macrophages by parasite-derived molecules / 中华地方病学杂志

As a major member of innate immunity, macrophage can eliminate pathogens through cell phagocytosis, antigen presentation and immune regulation, and play an important role in parasitic infections such as Echinococcus. Echinococcus can regulate the function of host macrophages through a variety of parasite-derived molecules, such as protein and nucleic acid molecules, and realize long-term parasitism in the host. This article focuses on the research progress of the role of macrophages in echinococcosis and the regulation of macrophages by parasite-derived molecules.

Intrathecal delivery of nusinersen using the Ommaya reservoir in a spinal muscular atrophy type 2 patient: a case report / 中华神经科杂志

Ommaya reservoir implantation is generally used in the treatment of hydrocephalus and intraventricular drug administration. Ommaya reservoir implantation in the subarachnoid space of the spinal cord for the intrathecal drug administration has not been carried out in China, and only several reports can be retrieved from PubMed. About 60%-90% of untreated patients with spinal muscular atrophy type 2 (SMA2) who survive to adulthood often have complex scoliosis and joint deformities. Nusinersen is an effective drug for the treatment of SMA2. And the route of administration is intrathecal injection, which is difficult for patients with severe scoliosis. This article summarizes the process of Ommaya reservoir implantation and postoperative drug administration in a patient with complex scoliosis type SMA2, which provides a new method for clinical treatment of this disease.

Deciphering the pathogenicity of COL4A4 heterozygous splicing mutations and the genotype-phenotype correlation in autosomal dominant Alport syndrome / 中华肾脏病杂志

Objective:Through the investigation of the pathogenicity of COL4A4 heterozygous splicing mutations and the genotype-phenotype correlation in autosomal dominant Alport syndrome (ADAS), to better understand the impact of COL4A4 heterozygous splicing mutations on ADAS. Methods:The study was a case series analysis. Patients from 5 ADAS families with COL4A4 heterozygous splicing mutations detected by whole exome sequencing were recruited by three hospitals. In vivo transcriptional analysis and/or in vitro minigene splicing assay were conducted to determine the splicing patterns and assess the pathogenicity of COL4A4 heterozygous splicing mutations. Results:In the five ADAS pedigrees carrying COL4A4 heterozygous splicing mutations, four novel ADAS splicing patterns were described. In pedigree 1-4, most patients presented with continuous hematuria or/and microalbuminuria. Otherwise,the proband in pedigree 4 presented with macroalbuminuria and the proband in pedigree 1 had progressed to chronic kidney disease stage 2 at the age of 70 years old. In pedigree 5, all patients developed end-stage renal disease between 28 and 41 years old. c.735+3A>G detected in pedigree 1 and pedigree 2 and c.694-1G>C detected in pedigree 3 both led to exon 12 skipping in COL4A4, resulting in 42 nucleotides in-frame deletion (c.694_735del). c.2056+3A>G detected in pedigree 4 led to COL4A4 exon 26 skipping, which caused in-frame deletion of 69 nucleotides (c.1988_2056del). c.2716+5G>T detected in pedigree 5 led to a 360 nucleotides large in-frame deletion, including 100 bp sequence at the 3'end of exon 29,the whole sequence of exon 30 and 89 bp sequence at the 5'end of exon 31 (c.2446_2805del). Conclusions:Renal prognosis differs significantly for patients with small in-frame deletions versus large in-frame deletion splicing abnormalities. Determination of the pathogenicity and the splicing patterns of COL4A4 heterozygous splicing mutations using in vivo and in vitro transcriptional analysis may provide renal prognostic information.

Comparative study of muscle content assessed by different anthropometric indicators in the diagnosis of GLIM malnutrition in elderly patients with intermediate and advanced malignant tumors / 肠外与肠内营养

Objective:To assess the concordance between different anthropometric indexes in the Global Leaders Initiated Malnutrition Standards(GLIM)and the Geriatric Risk Index(GNRI)for assessing muscle mass,and to explore performance-based criteria for GLIM muscle content appropriate for elderly patients with intermediate and advanced tumors.Methods:312 patients admitted to Shanghai Tenth People's Hospital from September 2022 to June 2023 were included.All patients were assessed nutritionally using the GLIM,applying the three methods of grip strength,upper arm circumference,and calf circumference as expressive criteria for assessing muscle content,and the diagnostic value of the three tools corresponding to the GLIM criteria was assessed using the GNRI as a reference standard.Results:Among 312 elderly patients with intermediate to advanced tumors,127(40.71％)and 138(44.23％),128(41.03％)and 162(51.92％)were diagnosed as malnourished based on the GNRI and GLIM---grip strength,GLIM---calf circumference,and GLIM---upper arm circumference in nutritional assessment,respectively.The GNRI and GLIM--Grip strength were both associated with incidence of complications and length of hospital stays.Using GNRI as a reference standard,GLIM-grip strength diagnosed malnutrition with good consistency(K value=0.692,P＜0.001),followed by calf circumference(K value=0.688,P＜0.001);compared with the other two indexes,the AUC of GLIM-grip strength was 0.851,with the correctness was 84.3％,with the best diagnostic value.Conclusion:Grip strength can be used as a practical and convenient muscle content performance-based criterion in the GLIM standards and is expected to be promoted in the diagnosis of malnutrition in elderly patients with intermediate and advanced malignancies.

Risk factors for bleeding and thrombotic events in critically ill patients undergoing extracorporeal membrane oxygenation / 中华急诊医学杂志

Objective:To investigate the risk factors for bleeding and thrombosis during extracorporeal membrane oxygenation (ECMO) therapy in critically ill patients and determine the best predictors of coagulation-related complications.Methods:A retrospective analysis was performed on patients who received ECMO for respiratory or circulatory failure at Xiangya Hospital of Central South University from January 2020 to December 2022. The outcome was whether bleeding or thrombosis occurred from 24 h after ECMO insertion to before weaning. The differences in demographic characteristics, weaning conditions, prognosis, routine blood tests, organ function, coagulation and blood product transfusion of each group were compared. Logistic regression analysis was used to evaluate the risk factors for bleeding and thrombosis, and ROC curve evaluation was used to assess their capacity to predict complications.Results:A total of 61 patients with ECMO were enrolled, with 21 cases of bleeding and 14 cases of thrombosis during ECMO. Compared with the nonbleeding group, the activated partial thromboplastin time, thromboplastin time (TT), and transfusions of frozen plasma and red blood cells were higher in the bleeding group (all P<0.05). Compared with the nonthrombotic group, the increase in body weight, D-dimer (DD), fibrinogen degradation product (FDP), and improvement of arterial oxygen partial pressure (ΔPO 2) within 24 h were significantly higher in the thrombotic group (all P<0.05). Logistic regression analysis revealed that TT ( OR=1.039, 95% CI: 1.006~1.072, P=0.018) and frozen plasma transfusion volume ( OR=1.046, 95% CI: 1.010-1.083, P=0.012) were risk factors for bleeding events. FDP ( OR=1.030, 95% CI: 1.009-1.051, P=0.005), DD ( OR=1.181, 95% CI: 1.044-1.336, P=0.008), and ΔPO 2 ( OR=1.007, 95% CI: 1.002-1.012, P=0.006) were risk factors for thrombosis. According to ROC curve analysis, the AUCs of TT, frozen plasma transfusion, and combined indexes for predicting bleeding were 0.712, 0.690, and 0.816, respectively. The combined indices had a cut-off value of 0.273, a sensitivity of 75.61%, and a specificity of 80.00%. The AUCs of FDP, DD, ΔPO 2, and combined FDP with ΔPO 2 for predicting thrombosis were 0.778, 0.748, 0.786, and 0.868, respectively. The cut-off value of the combined index was 0.157, the sensitivity was 68.09%, and the specificity was 92.86%. Conclusions:TT combined with frozen plasma transfusion volume predicted bleeding optimally, while FDP plus ΔPO 2 predicted thrombotic events better during ECMO treatment in critically ill patients.

Design of mobile containerized negative pressure chamber / 医疗卫生装备

Objective To design a mobile container-based negative pressure chamber compatible with kinds of carriers to isolate and treat patients with respiratory infectious diseases.Methods A negative pressure chamber with standard container sizes was developed whose enclosure structure involved in 2 mm-thick galvanized steel plate,10 mm-thick high-performance thermal isolation polyurethane foam board,2 mm-thick galvanized steel plate and 10 mm-thick integral inner panel.There were three functional areas included in the chamber for clean office area,semi-polluted passage and polluted ward with toilet.Negative pressure differences between the functional areas were generated by full DC air supply and exhaust system to form directional air flow in the chamber.The patient's exhaled air was purified before emission with the high-efficiency particulate air filtration system.The negative pressure chamber was equipped with a portable life monitoring and support device,a remote consultation and guidance system,a water and electricity support system and etc.Results Air quality tests showed that the negative pressure chamber met the national standards in air cleanliness,static pressure difference,number of dust particles,settled bacteria,microorganisms on the surface of the object and etc.Conclusion The negative pressure chamber compatible with kinds of carriers can be used for the isolation and emergency treatment of patients with respiratory infectious diseases and the long-distance transport of critically ill patients.[Chinese Medical Equipment Journal,2023,44(9):24-28]

Efficacy and safety of enteral nutrition with jejunostomy tube versus nasojejunal tube after radical resection of esophageal cancer: A systematic review and meta-analysis / 中国胸心血管外科临床杂志

@#Objective    To systematically evaluate the efficacy and safety of jejunostomy tube versus nasojejunal tube for enteral nutrition after radical resection of esophageal cancer. Methods    PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP and CBM databases were searched to collect the clinical effects of jejunostomy tube versus nasojejunal nutrition tube after radical resection of esophageal cancer from inception to October 2021. Meta-analysis was performed using RevMan 5.4 software. Results    Twenty-six articles were included, including 17 randomized controlled studies and 9 cohort studies, with a total of 35 808 patients. Meta-analysis results showed that: in the jejunostomy tube group, the postoperative exhaust time (MD=–4.27, 95%CI –5.87 to –2.66, P=0.001), the incidence of pulmonary infection (OR=1.39, 95%CI 1.06 to 1.82, P=0.02), incidence of tube removal (OR=0.11, 95%CI 0.04 to 0.30, P=0.001), incidence of tube blockage (OR=0.47, 95%CI 0.23 to 0.97, P=0.04), incidence of nasopharyngeal discomfort (OR=0.04, 95%CI 0.01 to 0.13, P=0.001), the incidence of nasopharyngeal mucosal damage (OR=0.13, 95%CI 0.04 to 0.42, P=0.008), the incidence of nausea and vomiting (OR=0.20, 95%CI 0.08 to 0.47, P=0.003) were significantly shorter or lower than those of the nasojejunal tube group. The postoperative serum albumin level (MD=5.75, 95%CI 5.34 to 6.16, P=0.001) was significantly better than that of the nasojejunal tube group. However, the intraoperative operation time of the jejunostomy tube group (MD=13.65, 95%CI 2.32 to 24.98, P=0.02) and the indent time of the postoperative nutrition tube (MD=17.81, 95%CI 12.71 to 22.91, P=0.001) were longer than those of the nasojejunal nutrition tube. At the same time, the incidence of postoperative intestinal obstruction (OR=6.08, 95%CI 2.55 to 14.50, P=0.001) was significantly higher than that of the nasojejunal tube group. There were no statistical differences in the length of postoperative hospital stay or the occurrence of anastomotic fistula between the two groups (P>0.05). Conclusion    In the process of enteral nutrition after radical resection of esophageal cancer, jejunostomy tube has better clinical treatment effect and is more comfortable during catheterization, but the incidence of intestinal obstruction is higher than that of traditional nasojejunal tube.

Preparation quality control and clinical application observation of pooled platelets with leukocytes reduced / 中国输血杂志

【Objective】 To investigate the preparation quality and clinical application effect of pooled platelets with leukocytes reduced. 【Methods】 The quality and clinical effect of the buffy-coated method prepared pooled platelets leukocytes reduced (experimental group, n=40) and apheresis platelets leukocytes reduced (control group, n=40) were compared. 【Results】 The platelet volume (mL), platelet count (×1011), red blood cell contamination (×108) and residual white blood cell (×106) of the experimental group and control group were 278.90±7.92 vs 276.52±8.01, 2.66±0.09 vs 2.66±0.83, 0.54±0.42 vs 0.83±0.84, 0.29±0.54 vs 0.27±0.51, respectively, with no significant difference. The results of bacterial culture were negative, all met the requirements of relevant national standards. In addition, the CCI (×103, 24 h) and PPR (%) were 15.11±9.86 vs 14.61±12.55 and 54.23±18.70 vs 61.41±19.09 respectively, with no significant difference, indicating a certain degree of therapeutic effect. 【Conclusion】 The quality and clinical therapeutic effect of pooled platelets leukocytes reduced were consistent with that of apheresis platelets leukocytes reduced.

Research progress of angiotensin converting enzyme 2 co-expression in non-small cell lung cancer and SARS-CoV-2 / 中国胸心血管外科临床杂志

@#Since the first case of corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the end of 2019, the virus has spread rapidly around the world and has become a global public health problem. In the process of this virus epidemic, compared with the general population, cancer patients are considered to be highly susceptible people, especially the lung cancer patients. Some studies have shown that angiotensin converting enzyme 2 (ACE2) may be the pathway for SARS-CoV-2 to infect the host. At the same time, ACE2 is often abnormally expressed in non-small cell lung cancer. Therefore, understanding the respective mechanisms of ACE2 in COVID-19 and non-small cell lung cancer has extremely important reference value for the study of vaccines and therapeutic drugs, and also provides meaningful guidance for the protection of patients with lung cancer during the epidemic. This article reviews the possible invasive mechanism of ACE2 in SARS-CoV-2 and its abnormal expression in non-small cell lung cancer.

CT-guided Hook-wire versus microcoil localization in the pulmonary nodules surgery: A systematic review and meta-analysis / 中国胸心血管外科临床杂志

@# Objective    To systematically evaluate the application effect of CT-guided Hook-wire localization and CT-guided microcoil localization in pulmonary nodules surgery. Methods    The literatures on the comparison between CT-guided Hook-wire localization and CT-guided microcoil localization for pulmonary nodules were searched in PubMed, EMbase, The Cochrane Library, Web of Science, Wanfang, VIP and CNKI databases from the inception to October 2021. Review Manager (version 5.4) software was used for meta-analysis. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of studies. Results    A total of 10 retrospective cohort studies were included, with 1 117 patients including 473 patients in the CT-guided Hook-wire localization group and 644 patients in the CT-guided microcoil localization group. The quality of the studies was high with NOS scores>6 points. The result of meta-analysis showed that the difference in the localization operation time (MD=0.14, 95%CI −3.43 to 3.71, P=0.940) between the two groups was not statistically significant. However, the localization success rate of the Hook-wire group was superior to the  microcoil group (OR=0.35, 95%CI 0.17 to 0.72, P=0.005). In addition, in comparison with Hook-wire localization, the microcoil localization could reduce the dislocation rate (OR=4.33, 95%CI 2.07 to 9.08, P<0.001), the incidence of pneumothorax (OR=1.62, 95%CI 1.12 to 2.33, P=0.010) and pulmonary hemorrhage (OR=1.64, 95%CI 1.07 to 2.51, P=0.020). Conclusion    Although Hook-wire localization is slightly better than microcoil localization in the aspect of the success rate of pulmonary nodule localization, microcoil localization has an obvious advantage compared with Hook-wire localization in terms of controlling the incidence of dislocation, pneumothorax and pulmonary hemorrhage. Therefore, from a comprehensive perspective, this study believes that CT-guided microcoil localization is a preoperative localization method worthy of further promotion.

Case analysis of a patient with osimertinib-induced interstitial pneumonia who re-used EGFR-TKI therapy / 中国药房

OBJECTIVE To explore the way to re-use epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKI） in patients with EGFR-TKI-induced interstitial pneumonia （IP）， using osimertinib as an example. METHODS The IP treatment regimen and re-use of EGFR-TKI regimen in a patient who developed IP after the use of osimertinib were analyzed. And a literature review was made by combining the characteristics of the cases which reported in the literature and the characteristics of this case. RESULTS The patient’s IP symptoms due to treatment with osimertinib had resolved after treatment. The patient’s IP symptoms also did not worsen after using almonertinib in combination with hormones as re-use of EGFR-TKI regimen. However， almonertinib was discontinued as the patient experienced disease progression. The adverse reactions of IP needed to be dealt with in time， the EGFR-TKI should be discontinued and symptomatic treatment should be given. CONCLUSIONS EGFR-TKI targeted therapy could be re-selected by replacing EGFR-TKI， adjusting the dose of EGFR-TKI， and using hormones in combination. EGFR-TKI-induced adverse drug reactions of IP are rare， but need to be observed closely. If other EGFR-TKI is used， close monitoring of adverse reactions and curative effects are also required in order to adjust the patient’s treatment plan in time.

Association between blood pressure during 12-28 weeks gestation and pre-eclampsia: predictive value of blood pressure trajectories constructed by latent class growth modeling / 中华心血管病杂志

Objective: To explore the associations between blood pressure trajectories during pregnancy and risk of future pre-eclampsia in a large cohort enrolling pregnant women at gestational age of ~12 weeks from community hospitals in Tianjin. Latent class growth modeling (LCGM) was used to model the blood pressure trajectories. Methods: This was a large prospective cohort study. The study enrolled pregnant women of ~12 weeks of gestation in 19 community hospitals in Tianjin from November 1, 2016 to May 30, 2018. We obtained related information during 5 antepartum examinations before gestational week 28, i.e., week 12, week 16, week 20, week 24 and week 28. LCGM was used to model longitudinal systolic (SBP) and diastolic blood pressure (DBP) trajectories. For the association study, the predictors were set as SBP and DBP trajectory membership (built separately), the outcome was defined as the occurrence of preeclampsia after 28 weeks of gestation. Results: A total of 5 809 cases with known pregnant outcomes were documented. After excluding 249 cases per exclusion criteria, 5 560 cases with singleton pregnancy were included for final analysis. There were 128 cases preeclampsia and 106 cases gestational hypertension in this cohort. Univariate logistic regression and multivariate logistic regression showed the higher baseline SBP level and DBP level were related with increased risk of preeclampsia. Four distinctive SBP trajectories and DBP trajectories from 12 weeks to 28 weeks of gestation were identified by LCGM. After controlling for potential confounders (baseline BMI, being primipara or not, white blood cell counts, hemoglobin level, platelet counts and alanine aminotransferase level), the OR for SBP latent classification trajectory_ 4 was 4.023 (95%CI: 2.368 to 6.835, P<0.001), and the OR for SBP latent classification trajectory_3 was 1.854 (95%CI: 1.223 to 2.811, P=0.004). Logistic regression showed that: using the DBP latent classification trajectory_1 as the reference group, the OR for DBP latent classification trajectory_4 was 4.100 (95%CI: 2.571 to 6.538, P<0.001), and 2.632 (95%CI: 1.570 to 4.414, P<0.001) for DBP latent classification trajectory_2. After controlling for potential confounders (baseline BMI, being primipara or not, white blood cell counts, hemoglobin level, platelet counts and alanine aminotransferase level), the OR for DBP_traj_4 was 2.527 (95%CI: 1.534 to 4.162, P<0.001), and the OR for DBP_traj_3 was 1.297 (95%CI: 0.790 to 2.128, P=0.303), and 2.238 (95%CI: 1.328 to 3.772, P=0.002) for DBP_traj_2. Therefore, BP trajectories from 12 weeks to 28 weeks identified by LCGM served as novel risk factors that independently associated with the occurrence of preeclampsia. Receiver operating characteristic (ROC) curve analysis showed incremental diagnostic performance by combing baseline blood pressure levels with blood pressure trajectories. Conclusion: By applying LCGM, we for the first time identified distinctive BP trajectories from gestational week 12 to 28, which can independently predict the development of preeclampsia after 28 weeks of gestation.

Effect of acupuncture on HIF-1α/NLRP3 inflammatory signaling pathway in the rats with cerebral ischemia-reperfusion injury / 中国针灸

OBJECTIVE@#To observe the effects of Xingnao Kaiqiao (regaining consciousness and opening orifices) acupuncture therapy on the expression of hypoxia-inducible factor 1α (HIF-1α) and Nod-like receptor protein 3 (NLRP3) in cerebral ischemia-reperfusion rats, and to explore the mechanism of acupuncture against cerebral ischemia-reperfusion injury.@*METHODS@#Seventy-two male SD rats were randomly divided into a sham-operation group, a model group, an acupuncture group and a non-point acupuncture group, with 18 rats in each one. Using modified Longa thread embolization method, the rat model of acute focal cerebral ischemia was prepared; and after 2 h ischemia, the reperfusion was performed to prepared the model of cerebral ischemia-reperfusion. Immediately after reperfusion, Xingnao Kaiqiao acupuncture method was applied to bilateral "Neiguan" (PC 6) and "Shuigou" (GV 26) in the acupuncture group, while in the non-point acupuncture group, acupuncture was delivered at non-points and all of the needles were retained for 30 min in these two groups. The samples were collected 24 h after reperfusion in the rats of each group. Zea-Longa neurological deficit score was used to evaluate the degree of cerebral neurological impairment, TTC staining was adopted to observe the volume percentage of cerebral infarction, HE staining was provided to observe the morphological changes of brain, and Western blot was applied for detecting the expression of HIF-1α and NLRP3 proteins in the cerebral cortex on the right side.@*RESULTS@#Compared with the sham-operation group, neurological deficit score and volume percentage of cerebral infarction were increased in the model group (P<0.01), and HIF-1α and NLRP3 protein expression was elevated (P<0.01). Compared with the model group, neurological deficit score and volume percentage of cerebral infarction were decreased (P<0.01), and HIF-1α and NLRP3 protein expression was lower (P<0.01) in the acupuncture group. There was no significant difference in above indexes in the non-point acupuncture group compared with the model group (P>0.05). Compared with the sham-operation group, the brain tissue of the rats in the model group and the non-point acupuncture group was loose and edema, and the nuclei were shriveled. The brain tissue morphology in the acupuncture group was similar to that of the sham-operation group.@*CONCLUSION@#Acupuncture can alleviate cerebral ischemia-reperfusion injury, and its mechanism may be related to the regulation of HIF-1α/NLRP3 signaling pathway to attenuate inflammatory response.