Background: Pneumonia is one of the most common complications after lung resection. However, there are currently no reports of postoperative pneumonia in patients with bronchiectasis. Objectives: Our study aims to construct a new nomogram to predict the risk of postoperative pneumonia in patients with localized bronchiectasis. Design: The clinical data of patients with localized bronchiectasis from April 2012 to August 2022 were retrospectively analyzed. Methods: Independent risk factors were identified through simple linear regression and multiple linear regression analysis, and a new nomogram was constructed based on independent risk factors. The validity of the nomogram was evaluated using the consistency index (C-index), receiver operating characteristic curve, calibration chart, and decision curve analysis chart. Results: The new nomogram prediction model included five independent risk factors: tuberculosis history, smoking history, platelet–lymphocyte ratio (PLR), diffusing capacity of the lung for carbon monoxide, and controlled nutritional status score. The area under the curve of the prediction model is 0.870 (95% CI: 0.750–0.892), showing good discrimination ability, and the probability threshold was set at 0.2013. In addition, the calibration curve shows that the nomogram has good calibration. In the decision curve, the nomogram model showed good clinical net benefit. Conclusion: This study is the first to construct a nomogram prediction model for postoperative pneumonia of localized bronchiectasis, which can more accurately and directly assess the risk probability of postoperative pneumonia, and provide certain help for clinicians in prevention and treatment decisions.

With the application of clarithromycin for Helicobacter pylori treatment, the number of resistant strains has increased greatly and has become a problem for treatment. Here, a novel multiplex PCR-allele-specific extension (PCR-ASE) functionalized microfluidic diagnostic platform with advantages of low-cost, easy-to-use and high sensitivity was firstly fabricated and proposed. A biphasic amplification multiplex PCR-ASE assay was integrated and used for the rapid detection of different mutations at positions 2142/2143 in the 23S rRNA gene in a single tube, and the results can be read with the naked eye using a nucleic acid detection strip (NADS). Our data revealed good performance for the multiplex diagnostic platform, which had an analytical sensitivity of approximately 50 copies/reaction and the ability to detect hetero-resistance at proportions as low as 0.5 %. Furthermore, it had no cross-reactivity with 10,000 copies of the wild-type template. The performance of platform for detection of clarithromycin resistance in 25 tissue biopsies was compared to that of Sanger sequencing and found to be in complete concordance. Due to its efficiency and simplicity, the multiplex PCR-ASE functionalized detection platform has great advantages for clinical application using a conventional thermal cycler for the detection of clarithromycin resistance within 2 h.

Detection of single-based mutation (SbM), which is of ultra-low abundance against wild-type alleles, are typically constrained by the level of multiplexing, sensitivity for single-base resolution and quantification accuracy. In this work, an electrochemical quantitative polymerase chain reaction (E-PCR) platform was developed for multiplexed and quantitative SbM analysis in limited and precious samples with single-nucleotide discrimination. A locked nucleic acid (LNA)-mediated multiplexed PCR system in a single, closed tube setup was firstly constructed to selectively amplify the SbM genes while suppressing the wild-type alleles. The amplicons were detected simultaneously through hybridization with the sequence-specific hairpin probes anchored on a reduced graphene oxide-gold nanoparticles functionalized electrode surface. With the inclusion of an LNA-mediated PCR step upstream of the electrochemical detection, we improved the limit of detection (LOD) by 2 orders of magnitude, down to an ultralow-level of 5 copies μL-1. The platform achieved an ultra-sensitive and specific detection with 0.05% against a background of 10, 000 copies of wild-type alleles. It is highly adaptive and has the potential to enable expanded multiplexed detection in parallel, thus providing a universal tool for multiplexed SbM identification.

目的 探讨围术期行纤维支气管镜肺泡灌洗(BAL)对肺癌患者术后肺部炎症指标的影响.方法 回顾性研究2018年1月 ～2021年1月在首都医科大学附属北京天坛医院接受手术治疗的肺癌患者资料,其中未行围术期BAL的94例患者纳入常规组,行围术期BAL的94例患者纳入灌洗组.对比两组患者术后经口进食时间、术后下床活动时间、住院时间,对比两组患者术前、出院前呼吸力学指标呼吸做功(WOB)、氧合指数(PaO2/FiO2)、吸气阻力(RAW)、动态顺应性(Cdyn),血气分析指标血氧饱和度(SpO2)、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2),血清炎症指标超敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT),肺功能指标全力肺活量(FVC)、第1秒全力呼气容积(FEV1),运动耐力指标6 min步行试验(6MWT)的变化情况.结果 灌洗组患者术后经口进食时间、术后下床活动时间、住院时间均短于常规组,差异有统计学意义(P<0.05);出院前,两组患者PaO2/FiO2、Cdyn均较本组术前升高,WOB、RAW均较本组术前降低,灌洗组PaO2/FiO2、Cdyn均高于常规组,WOB、RAW均低于常规组,差异有统计学意义(P<0.05);两组患者SpO2较本组术前降低,PaO2、PaCO2较本组术前降低,灌洗组SpO2、PaO2均高于常规组,PaCO2低于常规组,差异有统计学意义(P<0.05);两组患者hs-CRP、IL-8、TNF-α、PCT均较本组术前降低,灌洗组均低于常规组,差异有统计学意义(P<0.05);两组患者FVC、FEV1、6MWT均较本组术前降低,灌洗组FVC、FEV1、6MWT均高于常规组,差异有统计学意义(P<0.05).结论 围术期纤维支气管镜肺泡灌洗能够有效清除患者肺部炎性分泌物,减轻患者肺部炎症程度,起到促进患者术后恢复、改善患者呼吸与肺功能的作用.

NXPH4 is discovered to be a neuropeptide-like glycoprotein, belonging to the Neurexophilins (Nxphs) family. NXPH4 shares a similar domain structure with NXPH1, which, however, is poorly understood in terms of its function. Bioinformatics analysis and experimental verification in this study confirmed the abnormal high expression of NXPH4 in non-small cell lung cancer (NSCLC) tissues and cells. Knockdown of NXPH4 by siRNA can inhibit the proliferation and migration of cells, resulting in significant cell cycle arrest in S1 phase. Furthermore, in NSCLC cells, NXPH4 was regulated by transcriptional activation of enhancer of zeste homolog 2 (EZH2) in its upstream. While downstream, NXPH4 could interact with CDKN2A and downregulate its protein stability, thus participating in the cell cycle regulation through interacting with cyclinD-CDK4/6-pRB-E2F signaling pathway. To sum up, the present study reveals a regulatory pathway of EZH2/NXPH4/CDKN2A in NSCLC, providing possible reference for understanding the function of NXPH4 in tumors.

目的 探讨胸腔镜肺癌切除术后下肢深静脉血栓形成(DVT)的危险因素.方法 选取首都医科大学附属北京天坛医院收治222例行胸腔镜肺癌切除术患者的临床资料,根据术后下肢DVT发生情况分为DVT组(n=74)和对照组(n=148).胸腔镜肺癌切除术后发生下肢DVT的影响因素采用Logistic回归分析.结果 术后,DVT组患者的纤维蛋白原(Fib)水平高于对照组患者,差异有统计学意义(P<0.05);术前D-二聚体>0.74 mg/L、术前Fib>3.46 g/L、术后Fib>3.54 g/L、术后卧床时间>72 h、术前化疗是胸腔镜肺癌切除术后发生下肢DVT的独立危险因素(P<0.05).结论 术前D-二聚体和Fib升高、术后Fib升高、卧床时间延长、术前化疗是胸腔镜肺癌切除后发生下肢DVT的独立危险因素,应该根据相关因素进行针对性监测及干预,降低下肢DVT的风险.

目的 分析食管癌根治术后患者院内感染病原菌分布特点及耐药性情况,为临床诊治提供依据.方法 回顾性分析2014年4月 ～2019年4月180例发生院内感染的食管癌根治术后患者的一般临床资料,总结病原菌培养结果 及多重耐药性情况.结果 食管癌根治术后患者在院治疗期间发生的最常见的院内感染是下呼吸道感染(32.8％),其次是手术切口(21.1％)、胸腔(15.0％)和上呼吸道感染(13.3％).180个标本共分离出276株病原菌,其中革兰阴性菌164株(59.4％),以大肠埃希菌(11.6％)最多;革兰阳性菌78株(28.3％),主要为金黄色葡萄球菌(8.3％);真菌34株(12.3％),以白色念珠菌为主(5.1％).药敏试验显示几种主要革兰阴性菌对头孢唑林、氨苄西林、阿莫西林-克拉维酸及复方新诺明具有较高耐药性,对头孢哌酮-舒巴坦、亚胺培南和美罗培南较为敏感;几种主要革兰阳性菌对青霉素、红霉素、阿奇霉素和头孢唑林具有较高耐药性,对万古霉素和利奈唑胺较敏感;几种主要真菌对氟康唑、两性霉素B具有较高耐药性,对酮康唑、咪康唑较为敏感.结论 食管癌根治术后患者最易发生院内感染的部位是下呼吸道,最常见的病原菌类型是革兰阴性菌,且耐药严重,存在多重耐药菌,临床上应该做好相应的预防工作及合理选择抗菌药物.

目的 分析老年肺癌患者术后发生院内肺部感染的病原菌分布特点及耐药性情况,为临床诊治提供一定参考依据.方法 回顾性分析2016年8月—2019年8月收治的496例老年肺癌手术患者的临床资料,统计术后发生院内肺部感染的情况,总结肺部感染痰培养的细菌分离株及多重耐药性情况.结果 496例老年肺癌患者术后发生院内肺部感染者117例(23.6％);共分离出162株病原菌,以革兰阴性菌(103株,63.58％)为主,其次为革兰阳性菌(38株,23.46％)和真菌(21株,12.96％).药物敏感(药敏)试验结果显示革兰阴性菌、革兰阳性菌及真菌对常用抗菌药物的耐药率均较高.结论 老年肺癌患者术后院内肺部感染发生率较高,最常见的病原菌是革兰阴性菌,且细菌耐药严重,甚至出现较多的多重耐药菌,临床上要加强病原菌的培养和药敏试验,合理选择抗菌药物.

Objective: To evaluate and compare the clinical value of early enteral nutrition (EEN) and total parenteral nutrition (TPN) af-ter esophageal cancer surgery. Methods: We retrospectively analyzed 237 patients who underwent esophageal cancer surgery at Bei-jing Shijitan Hospital from March 2011 to March 2019. They were assigned into two groups based on the postoperative nutritional sup-port used: EEN (136 cases) and TPN (101 cases). Nutritional status, liver function, recovery of gastrointestinal function, days of hospital-ization, and postoperative complications were compared between the two groups after propensity score matching. Results: Using 1 :1 nearest neighbor matching, we successfully matched 91 pairs of patients. The prealbumin (PA) level was significantly higher in the EEN group than in the TPN group 7 days after surgery (P<0.05); however, there was no significant difference in albumin (ALB) level before surgery, 3 or 7 days after surgery. Additionally, the levels of ALT and AST in the EEN group were significantly lower than those in the TPN group 3 and 7 days after surgery (P<0.05). The incidence of acid reflux, vomiting, and diarrhea in the EEN group was higher than that in the TPN group, while the incidence of pulmonary edema and pulmonary infection was lower in the EEN group than in the TPN group (P<0.05). Conclusions: Compared with TPN, EEN is associated with a high incidence of acid reflux, vomiting, and diarrhea after esophageal cancer surgery, but it has a lower impact on liver function. EEN can promote the recovery of intestinal function, improve nutritional indicators, and shorten hospitalization time.

Clinical practice plays a vital role in personnel training''s system, which is an important link in the process of medical education. The case-based learning(CBL) is a teaching mode that teacher explains specific cases, integrating abstract medical knowledge into the process of diagnosis and treatment, guiding students to link theory with practice. The problem-based learning(PBL) is a problem oriented teaching mode, which can guide students to independently explore the solution for the problem. This article will combine those two teaching methods. Taking advantage of both advantages, we explored the feasibility and implementation of this model in clinical practice teaching in thoracic surgery. This teaching mode which is worth popularizing, is more conducive to students to master the basic medical knowledge, arouse the enthusiasm of students, promote self-directed learning, strengthen the cultivation of students'' clinical thinking and decision-making ability, effectively improve the quality of teaching, which is worth to be promotion.

Objective To understand the current status of myopia among medical students and to analyze the related affecting factors.Methods A self-administered questionnaire survey was conducted among randomly selected 200 freshmen and sophomores from a medical university in Beijing.The database was built up using EpiData3.1software and SPSS17.0 was used for the analysis of data.Rank-sum test and Spearman′s rank correlation coefficient test were adopted for statistical analysis.Results A total of 183 students had completed the survey.The overall prevalence of myopia was 82.5%,of which mild,moderate and severe myopia accounting for 33.9%,40.4% and 8.2%,respectively.Heredity and poor habits of using eyes were the relevant factors of myopia(P0.05).The correlation coefficients of reading distance,reading posture,frequently lying and playing mobile phone and resting eyes when studying with myopia were 0.247,0.150,0.151 and 0.256,and the correlations were statistically significant(P0.05).Conclusions There is a high prevalence of myopia in medical students.Heredity and environment play an important role in the development of myopia.Appropriate reading habit is supposed to be the most effective way to prevent myopia.