OBJECTIVE: To investigate the control status of bronchial asthma (referred to as \"asthma\") in school-age children with normal pulmonary ventilation function and the occurrence of acute attacks within 1 year of follow-up.
METHODS: A retrospective analysis was conducted on clinical data of 327 children aged 6-14 years with bronchial asthma and normal pulmonary ventilation function from April to September 2021. Based on the measured value of one second rate (FEV1/FVC), the children were divided into the ≥80% group (267 cases) and the <80% group (60 cases). The pulmonary ventilation function, asthma control level, and occurrence of acute attacks within 1 year were compared between the two groups.
RESULTS: The baseline pulmonary ventilation function in the <80% group was lower than that in the ≥80% group, and the proportion of small airway dysfunction was higher than that in the ≥80% group (P<0.05). After standardized treatment for 1 year, the small airway function indices in the <80% group improved but remained lower than those in the ≥80% group (P<0.05). The rate of incomplete asthma control at baseline was 34.6% (113/327), and the asthma control level in the <80% group was lower than that in the ≥80% group (P<0.05). After standardized treatment for 1 year, the asthma control level in the <80% group remained lower than that in the ≥80% group, and the proportion of acute asthma attacks was higher than that in the ≥80% group (P<0.05).
CONCLUSIONS: Approximately one-third of school-age children with asthma still have incomplete asthma control when their pulmonary ventilation function is normal. Among them, children with measured FEV1/FVC<80% have an increased risk of acute asthma attacks and require close follow-up and strengthened asthma management.
目的: 探讨学龄期肺通气功能正常的支气管哮喘（简称“哮喘”）患儿病情控制情况及随访1年内急性发作情况。方法: 回顾性分析2021年4—9月327例6~14岁肺通气功能正常哮喘患儿临床资料。根据一秒率实测值，分为≥80%组（267例）和<80%组（60例），比较两组肺通气功能、哮喘控制水平差异，以及随访1年急性发作情况。结果: <80%组基线肺通气功能低于≥80%组，小气道功能障碍比例高于≥80%组（P<0.05）；规范治疗1年后，<80%组小气道功能指标均改善，但仍低于≥80%组（P<0.05）。入组时哮喘未完全控制率为34.6%（113/327），<80%组哮喘控制水平低于≥80%组（P<0.05）；规范治疗1年后，<80%组哮喘控制水平仍低于≥80%组，且哮喘急性发作比例高于≥80%组（P<0.05）。结论: 学龄期哮喘患儿在肺通气功能正常时，仍有约1/3为哮喘未完全控制，其中一秒率实测值低于80%的患儿哮喘急性发作风险增加，需密切随访，强化哮喘管理。.

OBJECTIVE: To explore the risk factors for incisional hernia (IH) recurrence following open prepertioneal repair.
METHODS: Patients diagnosed with primary IH who underwent open preperitoneal repair at our hospital were enrolled. Patients were assessed, and perioperative factors were collected. Recurrence surveys were performed at regular intervals throughout the long-term postoperative follow-up. The risk factors for IH recurrence were identified using univariate and multivariate analyses.
RESULTS: This study included 145 patients. Significant differences were found between recurrence and non-recurrence patients regarding pulmonary ventilation function (PVT), age, body mass index (BMI), mesh materials, type of surgery (clean, clean-contaminated, or contaminated), surgical site infections (SSIs), maximum width of the hernia defect (MWHD), and site of incisional hernia (P < 0.01). The univariate survival analysis revealed that PVT abnormalities, age > 70 years, BMI > 27 kg/m2, porcine small intestine submucosal (PSIS) mesh, non-clean surgery, SSIs, MWHD > 10 cm, and location in the lateral zones were significant factors for IH recurrence after open preperitoneal repair. The multivariate survival analysis showed that PVT abnormalities, age > 70 years, BMI > 27 kg/m2, and PSIS mesh were independent risk factors for IH recurrence after open preperitoneal repair.
CONCLUSIONS: We identified PVT abnormalities, age > 70 years, BMI > 27 kg/m2, and PSIS mesh as novel risk factors for IH recurrence after open preperitoneal repair.

OBJECTIVE: To investigate changes of pulmonary ventilation function and diffusion function in lung cancer patients after neoadjuvant immune checkpoint inhibitors (ICIs) therapy combined with chemotherapy treatment.
METHODS: Patients with newly diagnosed lung cancer (Ⅱa-Ⅲb) admitted to Zhejiang Cancer Hospital from October 2021 to July 2022, who received ICIs combined with chemotherapy for more than two courses were enrolled. Patients underwent pulmonary ventilation function and diffusion function assessments before and after treatment. The demographic information, sizes and locations of cancer lesions, doses and duration of ICIs used, pulmonary function results before and after treatment, and the tumor regression were documented. The changes of pulmonary function parameters before and after the treatment were analyzed with paired t test and Wilcoxon rank-sum test. The factors influencing the pulmonary function changes were analyzed by multiple linear Lasso regression and ridge regression.
RESULTS: Among the 52 patients, 50 cases were males (96.15%) and 43 cases were squamous carcinoma (82.69%). The medium age of the patients was 67 years. After neoadjuvant therapy, 36 patients (69.23%) showed remission of tumor lesions. After treatment, the parameters of pulmonary ventilation inspiratory vital capacity (IVC) and the area under the expiratory flow-volume curve (AREAex), and the parameter of pulmonary diffusion total lung capacity increased compared with the baseline (all P<0.05). Forced vital capacity (FVC) and forced expiratory volume in first second (FEV1) also showed an increasing trend. Multivariate linear Lasso regression and ridge regression showed that baseline IVC had a significant negative effect on IVC improvement (Beta=－0.435, t=－2.968, P<0.01), baseline TLC had a significant negative effect on the improvement of TLC (Beta=－0.266, t=－2.474, P<0.05), and the remission of obstructive pneumonia favored the improvement of TLC (Beta=0.308, t=2.443, P<0.05).
CONCLUSIONS: After ICIs neoadjuvant treatment combined with chemotherapy, the lung ventilation and diffusion function can be improved in lung cancer patients, particularly for those with reduced baseline ventilation and diffusion function.
目的: 探讨免疫检查点抑制剂（ICI）联合化疗新辅助治疗对肺癌患者肺通气功能和弥散功能的影响。方法: 纳入2021年10月到2022年7月就诊于浙江省肿瘤医院，且新诊断肺癌（分期Ⅱa~Ⅲb）、接受新辅助ICI联合化疗治疗两个疗程、ICI治疗前后均完成肺通气功能和弥散功能检查的患者。采集人口统计学信息、病灶大小与位置、治疗药物、治疗前后肺通气功能和弥散功能结果以及肿瘤退缩情况。通过配对t检验和秩和检验寻找通气功能和弥散功能中存在治疗前后差异的参数，并通过多元线性Lasso回归和岭回归筛选可能影响治疗后肺功能变化的因素。结果: 共纳入52例受试者，其中男性50例（96.15%），中位年龄67岁，鳞癌43例（82.69%）。36例（69.23%）患者新辅助治疗后肿瘤病灶出现了缓解（长短径和减少30%以上）。ICI治疗后，肺通气功能中吸气肺活量和流量容积环呼气曲线下面积较基线改善（均P<0.05）；弥散功能中肺总量较基线改善（P<0.05），用力肺活量和第一秒用力呼吸量有升高趋势。多元线性Lasso回归和岭回归分析结果显示，基线吸气肺活量会对吸气肺活量改善度产生显著的负向影响（Beta值=－0.435，t=－2.968，P<0.01），基线肺总量会对肺总量改善度产生显著的负向影响（Beta值=－0.266，t=－2.474，P<0.05），梗阻性肺炎改善也有利于肺总量改善（Beta值=0.308，t=2.443，P<0.05）。结论: 新辅助ICI联合化疗对肺癌患者肺通气功能和弥散功能有积极影响，基线通气和弥散功能越差，ICI新辅助治疗后改善越明显。.

At present, there is a preliminary clinical consensus that prone position ventilation (PPV) is beneficial to the treatment of acute respiratory distress syndrome (ARDS), and further research on the details of treatment and patients\' benefits will help to assess its effectiveness and safety.
To evaluate the timing, efficacy, and safety of different mechanical ventilation positions (MVP) in treating ARDS.
The results of clinical trials were directly or indirectly compared by network meta-analysis to compare the effects of different MVP. Two authors independently searched the papers published in PubMed, Embase, Cochrane Library, China Knowledge Infrastructure (CNKI), China Biomedical Discs (CBM), WanFang, and VIP database from January 2000 to August 2022. The outcome indicators were oxygenation index, mechanical ventilation time, ICU hospitalization time, in-hospital mortality, and incidence of adverse events. Two authors independently screened the literature, evaluated the quality of the studies, and completed the data extraction. Stata 14.0 was used to conduct a network Meta-analysis, and the intervention measures were ranked according to the surface under the cumulative ranking curve (SUCRA). Funnel plots were drawn to evaluate publication bias.
According to the inclusion and exclusion criteria, 75 studies (including 6333 patient data) were finally included. According to the analysis results, PPV was the best for improving the oxygenation index. The SUCRA values of mechanical ventilation time, ICU hospitalization time, and in-hospital mortality were ranked as PPV > lateral position ventilation (LPV) > supine position ventilation (SuPV) > semireclining position ventilation (SePV). The SUCRA values in the incidence of adverse events were ranked as LPV > PPV > SuPV > SePV. All outcome measures had good consistency and low statistical heterogeneity. Funnel plot analysis shows that papers reported within three days of mechanical ventilation time, over five days of mechanical ventilation time, and in-hospital mortality were more likely to have publication bias.
PPV has the best effect on improving the oxygenation index, reducing mechanical ventilation time, shortening ICU hospitalization time, and reducing in-hospital mortality. Early and long-term use of PPV to improve pulmonary ventilatory function will be the key to improving patients\' survival and quality of life with ARDS.
PPV significantly affects patients with ARDS, which can shorten the treatment time and reduce hospital costs. During the treatment, nursing observation should be strengthened to prevent adverse events.