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To develop and validate a nomogram for predicting postoperative pulmonary infection (PPI) in patients undergoing lung surgery.Single-center retrospective cohort analysis.A university-affiliated cancer hospital PARTICIPANTS: A total of 1,501 adult patients who underwent lung surgery from January 2018 to December 2020.Observation for PPI within 7 days after lung surgery.A complete set of demographics, preoperative variables, and postoperative follow-up data was recorded. The primary outcome was PPI; a total of 125 (8.3%) out of 1,501 patients developed PPI. The variables with p0.1 in univariate logistic regression were included in the multivariate regression, and multivariate logistic regression analysis showed that surgical procedure, surgical duration, the inspired fraction of oxygen in one-lung ventilation, and postoperative pain were independent risk factors for PPI. A nomogram based on these factors was constructed in the development cohort (area under the curve: 0.794, 95% CI 0.744-0.845) and validated in the validation cohort (area under the curve: 0.849, 95% CI 0.786-0.912). The calibration slope was 1 in the development and validation cohorts. Decision curve analysis indicated that when the threshold probability was within a range of 0.02-to-0.58 and 0.02-to-0.42 for the development and validation cohorts, respectively, the nomogram model could provide a clinical net benefit.The authors developed and validated a nomogram for predicting PPI in patients undergoing lung surgery. The prediction model can predict the development of PPI and identify high-risk groups.

Carotid artery stenosis (CAS) can cause ischemic stroke, and clinical intervention for CAS is critical clinically. The purpose of this study was to explore the expression changes of microRNA-486-5p in the serum of patients with CAS and its possible mechanism. Ninety-one cases with asymptomatic CAS were recruited, and serum levels of miR-486-5p were measured using RT-qPCR. The diagnostic ability was evaluated by drawing the receiver operating characteristic (ROC) curve. Human aortic endothelial cells (HAECs) were treated with oxidized low-density lipoprotein (oxLDL) to establish cell model, and cell proliferation and apoptosis were tested. The markers of cell inflammation and oxidative stress were detected via ELISA. The target gene was analyzed using bioinformatics analysis combined with luciferase reporting assay. CAS cases exhibited significantly low serum miR-486-5p levels in comparison with the control group and can identify asymptomatic CAS. Serum miR-486-5p manifested a negative correlation with the degree of carotid stenosis. Underexpression of miR-486-5p was also detected in ox-LDL treated HAECs. OxLDL treatment contributes to inflammatory response and oxidative stress of HAECs; however, these adverse impacts caused by ox-LDL were reversed by miR-486-5p upregulation. NFAT5 was confirmed to be the target gene of miR-486-5p in HAECs. MiR-486-5p serves as a promising biomarker for the early identification of CAS. Overexpression of miR-486-5p can prevent endothelial dysfunction, and the mechanism might be related to anti-inflammation and anti-oxidation via targeting NFAT5.

The choice of friction interface has always been a controversial topic in hip arthroplasty. Although the metal-on-metal (MoM) interface has gradually faded out of our vision, its revision is a clinical difficulty. Adverse reactions to metal debris (ARMD) is the most common indication for MoM hip arthroplasty revision, and the clinical results of hip arthroplasty due to ARMD are not satisfactory. At present, the indications and suggestions for revision of ARMD are not uniform. In this article, the clinical diagnosis, indications of revision, risk factors of prognosis, intraoperative suggestions and reasons for revision of ARMD were summarized. This article briefly introduces the diagnosis and treatment strategies and precautions of hip arthroplasty due to ARMD, in order to provide reference for such patients in clinical practice.

Objectives We aimed to investigate the psychological problems on people infected with SARS-CoV-2 during the pandemic. Methods In this living systematic review and meta-analyses, we searched seven electronic databases for cross-sectional studies and longitudinal studies on psychological problems on COVID-19 patients from Jan 1, 2020 to Oct 7, 2020. The primary outcome was prevalence of various psychological problems such as anxiety, depression, stress, insomnia, somatization, and fear. We pooled data for prevalence with their 95% confidence interval (CI) using random effect models and assessed the study quality based on the 11-item checklist recommended by the Agency for Healthcare Research and Quality. Results Fourty-four studies, including studies from China(35), Italy(2), Iran(2), India(1), Korea(1), Ecuador(1), Switzerland(1), Germany(1), were identified by comprising a total of 8587 completed questionnaires and 38 studies for meta-analyses. The prevalence of anxiety, depression, post-traumatic stress disorder(PTSD), insomnia, somatization, and fear in patients with COVID-19 was 16.6% (10.1%-23.1%), 37.7% (29.3%-46.2%), 41.5% (9.3%-73.7%), 68.3% (48.6%-88.0%), 36.5% (20.2%-52.8%), 47.6% (9.4%-85.7%), respectively. The prevalence of anxiety, depression, and insomnia in severe COVID-19 patients (intensive care unit inpatients) was higher than mild or clinically stable COVID-19 patients. Limitations A significant degree of heterogeneity in terms of populations, sampling methods, scales was noted across studies. Conclusions There existed high proportions of COVID-19 patients with psychological problem. The prevalence of psychological problems was closely related to the patients themselves, their surroundings and social support. It is imperative to provide ontime psychological care service for COVID-19 patients and to follow-up them for a longer period.

Background The surgical approaches remain controversial for the treatment of middle and distal-third humeral shaft (MDTHS) fractures. This study compared clinical effects of the anterolateral approach with two incisions (AATI) and the posterior median approach (PMA) in the treatment of MDTHS fractures. Methods A retrospective analysis was carried out. One hundred sixty-six patients with MDTHS fractures were selected from January 2015 to January 2017 in Xi’an Hong Hui Hospital. According to surgical approaches, patients were divided into AATI (86 cases) and PMA group (80 cases). All patients were treated with open reduction and plate fixation. Operation indexes were compared, including incision length, operation time, and bleeding. Bryan-Morrey score was used to evaluate elbow joint function. Complication incidence was compared, such as incision infection, iatrogenic radial nerve injury, and nonunion. Results The AATI group showed smaller incision length, less bleeding, lower iatrogenic radial nerve injury rate, and better elbow function than that of PMA group (P Conclusions The middle and distal-third humeral shaft fractures can be successfully cured by both approaches. Compared with the posterior median approach, it has better clinical effects of the anterolateral approach with two incisions, which is worthy of clinical application and promotion.

Background Perioperative transfusion can reduce the survival rate in colorectal cancer patients. The effects of transfusion on the short- and long-term prognoses are becoming intriguing. Objective This systematic review and meta-analysis aimed to define the effects of perioperative transfusion on the short- and long-term prognoses of colorectal cancer surgery. Results Thirty-six clinical observational studies, with a total of 174,036 patients, were included. Perioperative transfusion decreased overall survival (OS) (hazard ratio (HR), 0.33; 95% confidence interval (CI), 0.24 to 0.41; P

Osteosarcoma is a malignant tumor in bones that is common in children and adolescents. MicroRNAs (miRs) are small non-coding RNAs that are associated with various kinds of tumors. miR-21 is one of the most frequently overexpressed microRNAs in osteosarcoma. Curcumin is a naturally occurring phenolic compound that has antitumor properties. Curcumin significantly inhibits osteosarcoma. However, the role of miR-21 and its target gene, reversion-inducing cysteine-rich protein with kazal motifs (RECK), in the anticancer activity of curcumin against osteosarcoma remains unclear. The aim of this study is to investigate the effect(s) of curcumin on osteosarcoma cell proliferation and elucidate its molecular mechanism. Cell counting kit-8, colony formation and flow cytometry assays were performed to study cell proliferation and apoptosis. Real time-polymerase chain reaction was used to determine the expression of miR-21 and RECK. Wnt/β-catenin signaling pathway proteins were detected by Western Blot. We hereby show that curcumin upregulated the expression of RECK via miR-21, thereby subsequently regulating Wnt/β-catenin signaling leading to the inhibition of osteosarcoma.

BACKGROUND Intra-operative hypotension might induce poor postoperative outcomes in non-cardiac surgery, and the relationship between the level or duration of Intra-operative hypotension (IOH) and postoperative adverse events is still unclear. In this study, we performed a meta-analysis to determine how IOH could affect acute kidney injury (AKI), myocardial injury and mortality in non-cardiac surgery. METHODS We searched PubMed (Medline), Embase, Springer, The Cochrane Library, Ovid and Google Scholar, and retrieved the related clinical trials on intra-operative hypotension and prognosis in non-cardiac surgery. RESULTS Fifteen observational studies were included. The meta-analysis showed that in non-cardiac surgery, intra-operative hypotension (mean arterial pressure [MAP]) 10 minutes: OR = 1.35, 95% CI (1.1, 1.67), I2 = 52.6%, P = .004] and myocardial injury [1-5 minutes: OR = 1.16, 95% CI (1.01, 1.33), I2 = 30.6%, P = .04; 5-10 minutes: OR = 1.34, 95% CI (1.01, 1.77), I2 = 70.4%, P = .046; >10 minutes: OR = 1.43, 95% CI (1.18, 1.72), I2 = 39.4%, P

To investigate the effects of cryptotanshinone (an active ingredient of Salvia Miltiorrhiza) inhibition of angiogenesis, the toxicity of cryptotanshinone was assayed in human hepatic sinusoidal endothelial cells (HHSEC) by CCK8 method. Max dose without toxicity is 10 μmol·L(-1). The proliferation of HHSEC were induced by the endothelial cell growth supplement (ECGS), with 2.5 μmol·L(-1) sorafenib as the positive control. Cell proliferation was analyzed by EdU assay. Cell viability was analyzed by CCK8 method. The expression of vWF was analyzed by immunofluorescence method. Fluorescence probe method was used to detect the intracellular nitric oxide (NO) levels. Tube formation of HHSEC and transgenic zebrafish were also observed to evaluate the effects of cryptotanshinone against angiogenesis. Compared with normal control, there is a proliferation of HHSEC induced by ECGS. The expression of vWF and the NO levels increased significantly. Cryptotanshinone inhibited the proliferation, down regulated the expression of vWF and the NO levels. Further, cryptotanshinone inhibited the tube formation of HHSEC and reduced the number of functional vessels in transgenic zebrafish. The results suggest that cryptotanshinone could inhibit angiogenesis by regulating the HHSEC cell function.

There is a high incidence of postoperative cardiopulmonary complications after thoracic surgery with one lung ventilation (OLV), the effect of general anesthetics on intraoperative cardiopulmonary function and postoperative complications is still unclear.We searched the Embase, PubMed, Cochrane Library, Springer, Wiley, CNKI, VIP and Wanfang databases for randomized controlled trials (RCTs) in which inhalation anesthesia and intravenous anesthesia were compared; intraoperative cardiopulmonary function and postoperative complications were assessed in patients undergoing thoracic surgery with intraoperative one-lung ventilation (OLV).Twenty-three RCTs with a total of 1349 patients were included. Compared with intravenous anesthesia, inhalation anesthesia significantly increased pulmonary shunt fraction (Qs/Qt) (mean: 5.72, 95% CI: 3.93 to 7.51, P0.0001), and improved Cardiac Index (CI) (mean difference [MD]: 0.19, 95% CI: 0.10 to 0.28, P0.0001), but decreased Oxygenation Index (OI) during OLV intraoperatively (MD: -27.37, 95% CI: -43.92 to -10.82, P=0.001). Inhalation anesthesia could reduce postoperative pulmonary complications (RR: 0.47, 95% CI: 0.33 to 0.66, P0.0001), but did not reduce postoperative cardiac adverse events (P0.05).Inhalation anesthesia can preserve intraoperative cardiac function and reduce postoperative pulmonary complications in patients undergoing thoracic surgery with OLV; although it decreases intraoperative pulmonary function, inhalation anesthesia may be superior to intravenous anesthesia in thoracic surgery. Publication bias existed in some included studies, and the sample size was not large enough in CI and cardiac adverse events.

INTRODUCTION Postoperative major adverse cardiac events (MACEs) are the main cause of postoperative mortality, and controversies exist regarding the effects of anesthesia methods on postoperative MACEs and mortality in high-risk cardiac patients after non-cardiac surgeries. EVIDENCE ACQUISITION A Meta-analysis about the effect of anesthesia methods on postoperative MACEs and mortality in high-risk cardiac patients undergoing intermediate- or high-risk non-cardiac surgeries was conducted; Chinese databases (SinoMed, CNKI, Wanfang, and VIP) and English databases (Medline, EMBASE, PubMed, Springer, Ovid, the Cochrane Library, and Google scholar) were searched. EVIDENCE SYNTHESIS Twenty-seven randomized controlled trials (RCTs) were included and 35340 patients were involved. The cardiac troponin I level (cTnI) on postoperative day 1 (MD: -0.39, 95% CI: -0.45--0.34, P

A new phenolic glycoside, syringic acid 4-O-β-D-glucopyranosyl-(1 → 5)-α-L-rhamnopyranoside (1), together with 12 known compounds consisting of eight phenolic glycosides (2-9), two phenolic acids (10 and 11), and two norsesquiterpenoids (12 and 13), was isolated from the methanol extract of the bark of Magnolia officinalis. Their structures were elucidated on the basis of spectroscopic analysis and chemical methods. Compounds 1-11 were evaluated for their inhibitory activities against fructose-1,6-bisphosphatase, aldose reductase, lipase, dipeptidyl peptidase-IV, α-glucosidase, and three cancer cell lines. However, all the compounds showed weak or no activities in these tests.

The bark of Magnolia officinalis is a well-known Traditional Chinese Medicine. In the present study, two new alkaloids, named (S)-4-keto-magnoflorine (6) and (R)-3,4-dehydromagnocurarine (11), together with seven known alkaloids: (S)-magnoflorine (5), trans/cis N-feruloylputrescine (7/8), (R)-magnocurarine (10), (S)-tembetarine (12), (R)-oblongine (14), and (R)-asimilobine (17) were isolated and their structures elucidated by spectroscopic methods, including 1D, 2D NMR, and HRESI-MS. The absolute configurations of the isoquinoline alkaloids 5, 6, 10-12, 14, and 17 were determined by CD. In vitro inhibitory activities against aldose reductase, lipase, α-glucosidase, DPP-IV and three cancer cell lines (A549, Bel-7402, and HCT-8) were evaluated for all isolated compounds. However, all compounds showed weak activities in all tests at the same concentration as the positive control drugs. An HPLC-ESI-MS(n) method has been established for screening of alkaloids in the bark of M. officinalis. A total of 23 alkaloids were identified or tentatively characterized; including 13 aporphines, eight benzylisoquinolines and two amides. Plausible fragmentation pathways of the representative compounds 6, 7/8, 11, and 17 were proposed in the present study.

This study was to investigate the clinical and pathological characteristics, curative effect and prognosis of primary central nervous system lymphoma (PCNSL).The clinical and pathological features, diagnosis and treatment, curative efficacy and survival rate of 20 cases of primary central nervous system lymphoma were retrospectivaly analyzed.The indicated that the clinical manifestations included headache, paralysis, seizures, dizziness and mental acuity, etc. There were 7 cases with single focus of lesion, 13 cases with multiple foci of lesions. The pathologic examimation showed 1 case of peripheral T-cell lymphoma and 19 cases of diffuse large B cell lymphoma, they all were from non-germinal center. Out of 20 cases, 11 cases with Ki-6775%,6 cases with Ki-67 50%-75%, 2 cases with Ki-67 25%-50% and 1 case with Ki-67 10%. Therapeutic evaluation were as follows: 10 cases with CR, 2 cases with PR, 6 cases with PD in 18 patients recieved treatment. The use of ritusimab in treatment or no use and number of lesion foci in cranium were related to survival time (P0.05) . The survival time in group with Ki-67(+)75% was longer than that in group with Ki-67(+)75% (P = 0.042). Age and CSF-TP level were related to curative effect (P0.05) .There is no specific clinical manifestation. The physical examination and imageological diagnosis of PCNSL, as well as pathological biopsy are necessary for diagnose of PCNSL. The factors for poor prognosis include age60 years, CSF-TP600 mg/L, multiple lesions and Ki-67(+)75%. PCNSL has high malignancy and poor prognosis. The chemotherapy based on high dose of MTX (among which MTX combined with rituximab) and HSCT after CR are the best treatment regimen for DLBCL.

During the long-term evolutionary history, the interaction between virus and host has driven the first-line barrier, innate immunity, to invading pathogens. Innate immune factor TRIM5α and host peptidyl-prolyl cis-trans isomerase Cyclophilin A are two key players in the interaction between HIV-1 and host. Interestingly, Cyclophilin A is retrotransposed into the critical host gene, TRIM5, locus via LINE-1 element in some primate species including New World monkeys and Old World monkeys. This review aims to comprehensively discuss the sensing and immune activation procedures of TRIM5α innate signaling pathway through Cyclophilin A. It will then present the production of TRIMCyp chimeric gene and the different fusion patterns in primates. Finally, it will summarize the distinct restriction activity of TRIMCyp from different primates and explain the current understanding on the innate immune mechanisms involved in the early phase of the viral life cycle during HIV-1 replication.

To explore the toxic effect of fluoride on the human thyroid cells (Nthy-ori 3-1) and its mechanism.Nthy-ori 3-1 cells were exposed to 0.0, 0.1, 1.0, 3.0 mmol/L of sodium fluoride (NaF) in vitro. After 24 hours incubation, 3 (4,5-Dimethylthiazol-z-yl)-3, 5-diphenyltetrazolium bromide (MTT) assay and lactate dehydrogenase (LDH) assay were used to measure cell viability and the LDH leakage rate. Reactive oxygen species (ROS) level, constituent ratio of the cell cycle, and apoptosis rate were measured by flow cytometry.Comparing to viability of control group (set as 100.00%), the cell viability of the 1.0, 3.0 mmol/L fluoride-treated groups (76.64 +/- 9.13)%, (64.04 +/- 6.32)% were significantly decreased (all P values0.01). LDH leakage rate and ROS level of the 3.0 mmol/L fluoride-treated group ((48.66 +/-7.15)%, (29993.50 +/- 1786. 86) FI) were significantly increased (all P values0.01) compared to control group ((35.24 +/- 3.02)%, (13021.33 +/- 1067.55) FI). The G0/G1 phase cells of the 1.0 mmol/L fluoride-treated group ((40.76 +/- 5.65)%) were lower than control group (60.09 +/- 1.76)% (P0.01), yet the percentage of cells in S phase ((54.05 +/- 4.59)%) were higher than the control group (32.59 +/- 2.43) % (P0.01). Comparing to control group ((9.64 +/- 3.44)%), the percentage of apoptosis cells increased in the 3.0 mmol/L fluoride-treated group ((20.09 +/- 3.22)%) (P0.01).To Nthy-ori 3-1 cells, fluoride under experimental concentrations decreases cell viability, improve the LDH leakage rate, and ROS level. It blocks the cells in S phase and induce cell apoptosis.

To evaluate the clinical efficacy and safety of dexketoprofen trometamol in the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).A total of 115 patients with CP/CPPS were divided into a dexketoprofen trometamol group (n = 40), treated with dexketoprofen trometamol (25 mg, tid) and terazosin (2 mg, qn), an indometacin group (n = 40) given indometacin (25 mg, tid) and terazosin (2 mg, qn), and a terazosin group (n = 35) administered terazosin (2 mg, qn) only, all treated for 4 weeks. Scores on the NIH-chronic prostatitis symptom index (NIH-CPSI) were obtained before and after the treatment, and the efficacy and adverse events were observed and compared.The NIH-CPSI scores were significantly improved after the treatment in all the three groups. The clinical efficacy was significantly better in the dexketoprofen trometamol and indometacin groups than in the terazosin group (P0.05), but with no significant difference between the former two (P0.05). The rates of adverse events were 10.00%, 18.57% and 27.50% in the dexketoprofen trometamol, terazosin and indometacin groups, significantly lower in the former two than in the latter one (P0.05).The combination of dexketoprofen trometamol with terazosin could effectively improve the clinical symptoms of CP/CPPS, better than terazosin in therapeutic efficacy and than indometacin in drug tolerance.

Objective In Old World monkeys, the tripartite motif 5alpha (TRIM5alpha) protein confers resistance to HIV-1 infection following virus entry into host cells. However, the pig-tailed macaque (Macaca nemestrina) is an exception and is susceptible to HIV-1 infection. This study dissects the molecular mechanism of the pig-tailed macaque's susceptibility to HIV-1 infection. Methods Genomic sequencing and expression analysis of the TRIM5alpha gene was conducted in the pig-tailed macaque. A novel TRIM5-Cyclophilin A fusion gene isoform was identified and subsequently cloned into the pcDNA3.1(+) expression vector. This construct was transfected into HeLa-T4 or HeLa cells which were then infected with the HIV-1IIIB or HIV-GFP-VSVG pseudotyped virus, to examine the effects of the TRIM5-Cyclophilin A fusion protein on HIV-1 infection. Results A novel TRIM5-Cyclophilin A fusion gene (mnTRIMCyp) in the pig-tailed macaque was found and its fusion pattern is different from the known fusion gene in the owl monkey (owlTRIMCyp). TRIMCyp protein expression in transfected cells was confirmed by western blotting. The tests using HIV-1IIIB and HIV-GFP-VSVG pseudotyped virus indicated that mnTRIMCyp did not inhibit HIV-1 replication at various multiplicities of infection. Conclusions The mnTRIMCyp fusion protein does not restrict replication of HIV-1, which provides a potential molecular mechanism that might explain why the pig-tailed macaque is prone to HIV-1 infection, the only known exception in Old World monkeys.

The health effects of odors emitted from the human environment have received some discussion in the literature. Little has been written, however, about the health effects of odor emissions from renovation. The authors therefore conducted a cross-sectional study with a simple randomized sampling design. The sample was selected from a building-and-construction registry that registered all building and domestic renovation applications in Tianjin, China. Information on demographics, physical symptoms, and health status was collected via personal interviews. Air samples were also collected from each household for chemical analysis. Data were analyzed with weighted logistic-regression models. A significant association was found between exposure to odor emission and unspecific physical symptoms. After potential confounders were adjusted for, it was found that people who had been exposed to moderate-to-strong odor emissions from renovations were about four times more likely to report experiencing unspecific discomfort than were people who had been exposed to weak odor emissions (odds ratio = 4.05; 95 percent confidence interval = 1.49-11.03). The results indicate that odor emissions from domestic renovation have a detrimental effect on human physical health. This effect seemed to be independent from that generated by chemicals. Implications and prevention strategies are discussed.

Legionella is a bacterium identified as the causative agent of Legionnaires' disease commonly found in water and soil in natural environments and human habitats. While most studies are focused on cooling tower water as the source of infection, few studies have compared Legionella from cooling-tower water and water in man-made environments. This cross-sectional study with a randomized cluster sampling design aims to provide information on Legionella found in cooling-tower water and water in man-made environments. Legionella was identified using a dual analytical approach: the serological and the 16SrRNA semi-nest PCR methods. Nine different types of Legionella were identified with the Lp7 type detected in China for the first time. Results indicated slight but insignificantly increased odds (OR = 1.64, 95%CI = 0.54-4.98) of Legionella detection in cooling tower water as compared to water obtained from fountains and parks, suggesting that the mechanism of exposure plays an important role in the causal pathway of outbreaks of Legionnaires' disease.

To explore the health damage of indoor air pollution on residents by detecting the major indoor air pollutants and surveying the health indexes of residents.159 decorated houses were divided into 2 groups by whether the concentration of formaldehyde exceeded national standard. To analyze the health damage of formaldehyde and TVOC on residents, respectively.The concentrations of formaldehyde of the over standard group and the corresponding under standard group were (0.170 +/- 0.075) mg/m3 and (0.064 +/- 0.022) mg/m3, the concentrations of TVOC of the over standard group and the corresponding under standard group were (2.033 +/- 1.161) mg/m3 and (0.271 +/- 0.142) mg/m3. The incidence of the fatigue, nausea, eye symptoms, symptoms of nose, throat dessication, skin dessication, skin itching sensation and red swelling of the skin of the over standard group was significantly increased than that of the corresponding under standard group (P0.05). The incidence of the nausea, skin itching sensation and breathe hard of the TVOC over standard group was significantly increased than that of the corresponding under standard group (P0.05).Formaldehyde or TVOC will cause severe health damage.