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Clinical effect of laparoscopic radical resection of colorectal cancer based on propensity score matching

World Journal of Gastrointestinal Surgery 2024年第1期16卷 124-133页

作者： Yang Liu Xian-Xue Wang Yu-Lin Li Wen-Tao He Hong Li Hua Chen department of General Surgery Changde HospitalXiangya School of MedicineCentral South University(The First People’s Hospital of Changde City)Changde 415000Hunan ProvinceChina department of anesthesiology Changde HospitalXiangya School of MedicineCentral South University(The First People’s Hospital of Changde City)Changde 415000Hunan ProvinceChina

BACKGROUND The incidence of colorectal cancer(CRC)is increasing *** radical resection of CRC is a minimally invasive procedure preferred in clinical *** To investigate the clinical effect of laparoscopic radical resection of CRC on the basis of propensity score matching(PSM).METHODS The clinical data of 100 patients who received inpatient treatment for CRC at Changde Hospital,Xiangya School of medicine,Central South University(The First People’s Hospital of Changde City)were analyzed *** control group included patients who underwent open surgery(n=43),and those who underwent laparoscopic surgery formed the observation group(n=57).The baseline information of both groups was equipoised using 1×1 *** in the perioperative parameters,inflammatory response,immune function,degree of pain,and physical status between the groups were *** Thirty patients from both groups were successfully *** PSM,baseline data showed no statistically significant differences between the groups:(1)Periop-erative parameters:The observation group had a longer surgery time,less intra-operative blood loss,earlier first ambulation and first anal exhaust times,and shorter gastric tube indwelling time than the control group;(2)Inflammatory response:24 h after surgery,the levels of interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)between groups were higher than ***-6,CRP,and TNF-αlevels in the observation group were lower than in the control group;(3)Immune function:At 24 h after surgery,counts of CD4-positive T-lymphocytes(CD4+)and CD4+/CD8-positive T-lymphocytes(CD8+)in both groups were lower than those before surgery,whereas CD8+was higher than that before *** 24 h after surgery,both CD4+counts and CD4+/CD8+in the observation group were higher than those in the control group,whereas CD8+counts were lower;(4)Degree of pain:The visual analog scale scores in the observation gro

关键词： Colorectal cancer Laparoscopic Open surgery Inflammatory reaction Immune function Propensity score

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Protective eff ect and mechanism of nanoantimicrobial peptide ND-C14 against Streptococcus pneumoniae infection

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World Journal of Emergency medicine 2024年第1期15卷 28-34页

作者： Yangyang Guo Yaqi Sun Hongxia Wu Jian Lu Yuan Lin Jiaqing Zhu Meihong Lai Meiqi Zhang Jun Wang Jungang Zheng department of Intensive Care medicine Hangzhou Traditional Chinese Medicine Hospital Affi liated to Zhejiang Chinese Medical UniversityHangzhou 310021China National Children’s Regional Medical Center National Clinical Research Center for Child HealthChildren’s HospitalZhejiang University School of MedicineHangzhou 310052China department of Spleen and Stomach Diseases Hangzhou Traditional Chinese Medicine Hospital Affi liated to Zhejiang Chinese Medical UniversityHangzhou 310021China department of Ultrasonic medicine the First Affi liated Hospital of Ningbo UniversityNingbo 315010China department of anesthesiology the First Affi liated Hospital of Ningbo UniversityNingbo 315010China Zhejiang University School of medicine Hangzhou 310058China The First People’s Hospital of Yuexi County Yuexi 616650China

BACKGROUND:Streptococcus pneumoniae(***)is a common pathogen that causes bacterial ***,with increasing bacterial resistance,there is an urgent need to develop new drugs to treat *** *** with a 14-carbon saturated fatty acid(ND-C14)is a novel nanoantimicrobial peptide designed by modifying myristic acid at the C-terminus of humanα-defensin 5(HD5)via an amide ***,it is unclear whether ND-C14 is effective against lung infections caused by ***:In vitro,three groups were established,including the control group,and the HD5 and ND-C14 treatment groups.A virtual colony-count assay was used to evaluate the antibacterial activity of HD5 and ND-C14 against *** morphological changes of *** treated with HD5 or ND-C14 were observed by scanning electron *** vivo,mice were divided into sham,vehicle,and ND-C14 treatment *** in the sham group were treated with 25μL of phosphate-buffered saline(PBS).Mice in the vehicle and ND-C14 treatment groups were treated with intratracheal instillation of 25μL of bacterial suspension with 2×108 CFU/mL(total bacterial count:5×10^(6) CFU),and then the mice were given 25μL PBS or intratracheally injected with 25μL of ND-C14(including 20μg or 50μg),*** rates were evaluated in the vehicle and ND-C14 treatment *** burden in the blood and bronchoalveolar lavage fluid were *** lung histology of the mice was assessed.A propidium iodide uptake assay was used to clarify the destructive eff ect of ND-C14 against ***:Compared with HD5,ND-C14 had a better bactericidal eff ect against *** because of its stronger ability to destroy the membrane structure of *** in *** vivo,ND-C14 significantly delayed the death time and improved the survival rate of mice infected with ***-C14 reduced bacterial burden and lung tissue ***,ND-C14 had a membrane per

关键词： Streptococcus pneumoniae Antimicrobial peptides Humanα-defensin 5 Infection

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Personalized surgical recommendations and quantitative therapeutic insights for patients with metastatic breast cancer: Insights from deep learning

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Cancer Innovation 2024年第3期3卷 65-80页

作者： Enzhao Zhu Linmei Zhang Jiayi Wang Chunyu Hu Qi Jing Weizhong Shi Ziqin Xu Pu Ai Zhihao Dai Dan Shan Zisheng Ai School of medicine Tongji UniversityShanghaiChina Shanghai Engineering Research Center of Tooth Restoration and Regeneration Research Institute of StomatologyStomatological Hospital and Dental School of Tongji UniversityShanghaiChina Tenth People's Hospital of Tongji University School of MedicineTongji UniversityShanghaiChina department of anesthesiology and perioperative medicine Shanghai Fourth People's HospitalSchool of MedicineTongji UniversityShanghaiChina Shanghai Hospital Development Center ShanghaiChina Columbia University New YorkNYUSA School of medicine Royal College of Surgeons in IrelandUniversity of Medicine and Health SciencesDublinIreland department of Biobehavioral Sciences Columbia UniversityNew YorkNYUSA department of Medical Statistics School of MedicineTongji UniversityShanghaiChina Clinical Research Center for Mental Disorders Chinese-German Institute of Mental HealthShanghai Pudong New Area Mental Health CenterSchool of MedicineTongji UniversityShanghaiChina

Background:The role of surgery in metastatic breast cancer(MBC)is currently *** novel statistical and deep learning(DL)methods promise to infer the suitability of surgery at the individual ***:The objective of this study was to identify the most applicable DL model for determining patients with MBC who could benefit from surgery and the type of surgery ***:We introduced the deep survival regression with mixture effects(DSME),a semi-parametric DL model integrating three causal inference *** models were trained to make individualized treatment *** who received treatments in line with the DL models'recommendations were compared with those who underwent treatments divergent from the *** probability weighting(IPW)was used to minimize *** effects of various features on surgery selection were visualized and quantified using multivariate linear regression and causal ***:In total,5269 female patients with MBC were *** was an independent protective factor,outperforming other models in recommending surgery(IPW-adjusted hazard ratio[HR]=0.39,95%confidence interval[CI]:0.19–0.78)and type of surgery(IPW-adjusted HR=0.66,95%CI:0.48–0.93).DSME was superior to other models and traditional guidelines,suggesting a higher proportion of patients benefiting from surgery,especially breast-conserving *** debiased effect of patient characteristics,including age,tumor size,metastatic sites,lymph node status,and breast cancer subtypes,on surgery decision was also ***:Our findings suggested that DSME could effectively identify patients with MBC likely to benefit from surgery and the specific type of surgery *** method can facilitate the development of efficient,reliable treatment recommendation systems and provide quantifiable evidence for decision-making.

关键词： breast surgery causal inference deep learning metastatic breast cancer

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Prediction of Th17/Treg cell balance on length of stay in intensive care units of patients with sepsis

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Journal of Intensive medicine 2024年第2期4卷 240-246页

作者： Yu Wu Guosheng Wu Minyu Li Yongqing Chang Miao Yu Yan Meng Xiaojian Wan department of Intensive Care medicine Changhai HospitalNaval Medical UniversityShanghaiChina department of anesthesiology Bethune International Peace HospitalShijiazhuangHebeiChina department of Burns Changhai HospitalNaval Medical UniversityShanghaiChina department of Special Needs Clinic Changhai HospitalNaval Medical UniversityShanghaiChina

Background Prolonged length of stay(LOS)of sepsis can drain a hospital's material and human *** study investigated the correlations between T helper type 17(Th17)and regulatory T(Treg)balance with LOS in *** A prospective clinical observational study was designed in Changhai Hospital affiliated to Naval Medical University in Shanghai,China,from January to October *** patients diagnosed with sepsis and who met the inclusion and exclusion criteria were recruited and whether the levels of cytokines,procalcitonin,subtypes,and biomarkers of T cells in the peripheral blood were *** analyzed the correlation between these and *** Sixty septic patients were classified into two groups according to whether their intensive care unit(ICU)stay exceeded 14 *** patients with LOS≥14 days were older([72.6±7.5]years vs.[63.3±10.4]years,P=0.015)and had higher Sequential Organ Failure Assessment(SOFA)(median[interquartile range]:6.5[5.0–11.0]vs.4.0[3.0–6.0],P=0.001)and higher Acute Physiology and Chronic Health Evaluation(APACHE)II scores(16.0[13.0–21.0]vs.8.5[7.0–14.0],P=0.001).There was no difference in other demographic characteristics and cytokines,interleukin-6,tumor necrosis factor-α,and interleukin-10 between the two *** Th17/Treg ratio of sepsis with LOS<14 days was considerably lower(0.48[0.38–0.56]vs.0.69[0.51–0.98],P=0.001).For patients with LOS≥14 days,the area under the receiver operating characteristic curve for the Th17/Treg ratio was *** improved to 0.840 and 0.850 when combined with the SOFA and APACHE II scores,*** The Th17/Treg ratio was proportional to septic severity and can be used as a potential predictor of ICU stay in sepsis,presenting a new option for ICU practitioners to better care for patients with sepsis.

关键词： Sepsis Th17/Treg Length of stay Intensive care units

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Paravertebral block's effect on analgesia and inflammation in advanced gastric cancer patients undergoing transarterial chemoembolization and microwave ablation

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World Journal of Gastrointestinal Surgery 2024年第1期16卷 196-204页

作者： Ying-Fen Xiong Ben-Zhong Wei Yu-Feng Wang Xiao-Feng Li Cong Liu department of anesthesiology The First Affiliated Hospital of Nanchang UniversityNanchang 330006Jiangxi ProvinceChina department of anesthesiology Nanjing Gulou Hospital Group Yizheng HospitalYangzhou 211400Jiangsu ProvinceChina Nuclear medicine department Xuzhou Cancer HospitalXuzhou 221000Jiangsu ProvinceChina department of Radiology Xuzhou Cancer HospitalXuzhou 221000Jiangsu ProvinceChina department of Minimally Invasive Oncology Xuzhou New Health Hospital(Xuzhou Hospital Affiliated to Jiangsu University)Xuzhou 221000Jiangsu ProvinceChina

BACKGROUND Transarterial chemoembolization(TACE)combined with microwave ablation(MWA)is an effective treatment strategy for patients with advanced gastric cancer and liver ***,it may cause severe postoperative pain and inflammatory *** paravertebral block(PVB)is a regional anesthetic technique that provides analgesia to the thoracic and abdominal *** To evaluate the effect of PVB on postoperative analgesia and inflammatory response in patients undergoing TACE combined with MWA for advanced gastric cancer and liver *** Sixty patients were randomly divided into PVB and control *** PVB group received ultrasound-guided PVB with 0.375%ropivacaine preoperatively,whereas the control group received intravenous analgesia with *** primary outcome was the visual analog scale(VAS)score for pain at 6 h,12 h,24 h,and 48 h after the *** outcomes were the dose of sufentanil used,incidence of adverse events,and levels of inflammatory markers(white blood cell count,neutrophil percentage,C-reactive protein,and procalcitonin)before and after the *** The PVB group had significantly lower VAS scores at 6 h,12 h,24 h,and 48 h after the procedure compared with the control group(P<0.05).The PVB group also had a significantly lower consumption of sufentanil and a lower incidence of nausea,vomiting,and respiratory depression than did the control group(P<0.05).Compared with the control group,the PVB group had significantly lower levels of inflammatory markers 24 h and 48 h after the procedure(P<0.05).CONCLUSION PVB can effectively reduce postoperative pain and inflammatory responses and improve postoperative comfort and recovery in patients with advanced gastric cancer and liver metastasis treated with TACE combined with MWA.

关键词： Transarterial chemoembolization Microwave ablation Paravertebral block Visual analog scale Sufentanil Inflammatory markers

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Long-term effects of gestational diabetes mellitus on the pancreas of female mouse offspring

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World Journal of Diabetes 2024年第4期15卷 758-768页

作者： Enriqueta Muñoz-Islas Edgar David Santiago-SanMartin Eduardo Mendoza-Sánchez Héctor Fabián Torres-Rodríguez Laura Yanneth Ramírez-Quintanilla Christopher Michael Peters Juan Miguel Jiménez-Andrade Unidad Académica Multidisciplinaria Reynosa-Aztlán Universidad Autónoma de TamaulipasReynosa 88740TamaulipasMexico department of anesthesiology Wake Forest University School of MedicineWinston SalemNC 27101United States

BACKGROUND Prolonged fetal exposure to hyperglycemia may increase the risk of developing abnormal glucose metabolism and type-2 diabetes during childhood,adolescence,and adulthood;however,the mechanisms by which gestational diabetes mellitus(GDM)predisposes offspring to metabolic disorders remain *** To quantify the nerve axons,macrophages,and vasculature in the pancreas from adult offspring born from mouse dams with *** GDM was induced by *** of streptozotocin(STZ)in ICR mouse *** 12 wk old,fasting blood glucose levels were determined in *** 15 wk old,female offspring born from dams with and without GDM were sacrificed and pancreata were processed for *** quantified the density of sensory[calcitonin gene-related peptide(CGRP)]and tyrosine hydroxylase(TH)axons,blood vessels(endomucin),and macro-phages(CD68)in the splenic pancreas using confocal *** Offspring mice born from STZ-treated dams had similar body weight and blood glucose values compared to offspring born from vehicle-treated ***,the density of CGRP+and TH+axons,endomucin+blood vessels,and CD68+macrophages in the exocrine pancreas was significantly greater in offspring from mothers with GDM vs control ***,the microvasculature in the islets was significantly greater,but not the number of macrophages within the islets of offspring born from dams with GDM compared to control *** GDM induces neuronal,vascular,and inflammatory changes in the pancreas of adult progeny,which may partially explain the higher propensity for offspring of mothers with GDM to develop metabolic diseases.

关键词： Gestational diabetes mellitus Immunohistochemistry Confocal microscopy Pancreas Offspring

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Hapln1 promotes dedifferentiation and proliferation of iPSC-derived cardiomyocytes by promoting versican-based GDF11 trapping

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Journal of Pharmaceutical Analysis 2024年第3期14卷 335-347页

作者： Ding-Jun Hao Yue Qin Shi-Jie Zhou Bu-Huai Dong Jun-Song Yang Peng Zou Li-Ping Wang Yuan-Ting Zhao department of Spine Surgery Honghui HospitalXi'an Jiaotong UniversityXi'an710054China department of anesthesiology Honghui HospitalXi'an Jiaotong UniversityXi'an710054China department of Cardiovascular medicine Honghui HospitalXi'an Jiaotong UniversityXi'an710054China State Key Laboratory of Biotherapy/Collaborative Innovation Center for Biotherapy West China HospitalSichuan UniversityChengdu610041China

Hyaluronan and proteoglycan link protein 1(Hapln1)supports active cardiomyogenesis in zebrafish hearts,but its regulation in mammal cardiomyocytes is *** study aimed to explore the potential regulation of Hapln1 in the dedifferentiation and proliferation of cardiomyocytes and its therapeutic value in myocardial infarction with human induced pluripotent stem cell(hiPSC)-derived cardiomyocytes(CMs)and an adult mouse model of myocardial ***-CMs and adult mice with myocardial infarction were used as in vitro and in vivo models,*** single-cell RNA sequencing data were retrieved for bioinformatic *** results showed that recombinant human Hapln1(rhHapln1)promotes the proliferation of hiPSC-CMs in a dose-dependent *** a physical binding protein of Hapln1,versican interacted with Nodal growth differentiation factor(NODAL)and growth differentiation factor 11(GDF11).GDF11,but not NODAL,was expressed by ***11 expression was unaffected by rhHapln1 ***,this molecule was required for rhHapln1-mediated activation of the transforming growth factor(TGF)-β/Drosophila mothers against decapentaplegic protein(SMAD)2/3 signaling in hiPSC-CMs,which stimulates cell dedifferentiation and *** mouse Hapln1(rmHapln1)could induce cardiac regeneration in the adult mouse model of myocardial *** addition,rmHapln1 induced hiPSC-CM *** conclusion,Hapln1 can stimulate the dedifferentiation and proliferation of iPSC-derived cardiomyocytes by promoting versican-based GDF11 trapping and subsequent activation of the TGF-β/SMAD2/3 signaling ***1 might be an effective hiPSC-CM dedifferentiation and proliferation agent and a potential reagent for repairing damaged hearts.

关键词： Hapln1 Versican GDF11 iPSC-CMs Cardiomyocyte proliferation

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Clues for diagnosing misplaced central venous catheter in the right ascending lumbar vein during right femoral venous access

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World Journal of Clinical Cases 2024年第24期12卷 5473-5475页

作者： Joho Tokumine Kiyoshi Moriyama Tomoko Yorozu department of anesthesiology Kyorin University School of MedicineMitaka 181-8611TokyoJapan

The right ascending lumbar vein is difficult to detect on anteroposterior abdominalradiographs because it overlaps with the inferior vena cava on *** observation by medical providers may be a cue ***,knowledge of catheter misplacement of the right ascendinglumbar vein is also necessary,because misplacement cannot be suspected withoutthat awareness.

关键词： Central venous catheter Ascending lumbar vein Femoral vein Catheter misplacement Anteroposterior abdominal X-ray

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Inverse relationship between platelet Akt activity and hippocampal atrophy:A pilot case-control study in patients with diabetes mellitus

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World Journal of Clinical Cases 2024年第2期12卷 302-313页

作者： Haruhiko Tokuda Takamitsu Hori Daisuke Mizutani Tomoyuki Hioki Kumi Kojima Takashi Onuma Yukiko Enomoto Tomoaki Doi Rie Matsushima-Nishiwaki Shinji Ogura Hiroki Iida Toru Iwama Takashi Sakurai Osamu Kozawa department of Metabolic Research Research InstituteNational Center for Geriatrics and GerontologyObu 474-8511Japan department of Clinical Laboratory National Center for Geriatrics and GerontologyObu 474-8511Japan department of Pharmacology Gifu University Graduate School of MedicineGifu 501-1194Japan department of Neurosurgery Gifu University Graduate School of MedicineGifu 501-1194Japan department of Dermatology Central Japan International Medical CenterMinokamo 505-8510Japan department of anesthesiology and Pain medicine Gifu University Graduate School of MedicineGifu 501-1194Japan department of Emergency medicine Faculty of MedicineUniversity of ToyamaToyama 930-0194Japan department of Emergency and Disaster medicine Gifu University Graduate School of MedicineGifu 501-1194Japan Research Institute National Center for Geriatrics and GerontologyObu 474-8511Japan

BACKGROUND Akt plays diverse roles in *** is involved in the pathogenesis of type 2 diabetes mellitus(T2DM),which is caused by insulin *** also plays a vital role in human platelet ***,the hippocampus is closely associated with memory and learning,and a decrease in hippocampal volume is reportedly associated with an insulin-resistant phenotype in T2DM patients without *** To investigate the relationship between Akt phosphorylation in unstimulated platelets and the hippocampal volume in T2DM *** Platelet-rich plasma(PRP)was prepared from the venous blood of patients with T2DM or age-matched *** pellet lysate of the centrifuged PRP was subjected to western blotting to analyse the phosphorylation of Akt,p38 mitogen-activated protein(MAP)kinase and glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Phosphorylation levels were quantified by densitometric *** volume was analysed using a voxel-based specific regional analysis system for Alzheimer’s disease on magnetic resonance imaging,which proposes the Z-score as a parameter that reflects hippocampal *** The levels of phosphorylated Akt corrected with phosphorylated p38 MAP kinase were inversely correlated with the Z-scores in the T2DM subjects,whereas the levels of phosphorylated Akt corrected with GAPDH were ***,this relationship was not observed in the control *** These results suggest that an inverse relationship may exist between platelet Akt activation and hippocampal atrophy in T2DM *** findings provide insight into the molecular mechanisms underlying T2DM hippocampal atrophy.

关键词： Akt Platelet Hippocampal atrophy Magnetic resonance imaging Diabetes mellitus

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Operation room nursing based on humanized nursing mode combined with nitric oxide on rehabilitation effect after lung surgery

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World Journal of Clinical Cases 2024年第18期12卷 3368-3377页

作者： Qiao-Li Wang Zhi-Bo Wang Jin-Fu Zhu department of anesthesiology and perioperative medicine The First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029Jiangsu ProvinceChina department of Thoracic Surgery Jiangsu Provincial People’s HospitalNanjing 210029Jiangsu ProvinceChina department of Cardiovascular Surgery The First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029Jiangsu ProvinceChina

BACKGROUND With advancements in the diagnosis and treatment of lung diseases,lung segment surgery has become increasingly *** rehabilitation is critical for patient recovery,yet challenges such as complications and adverse outcomes *** humanized nursing modes and novel treatments like nitric oxide inhalation may enhance recovery and reduce postoperative *** To evaluate the effects of a humanized nursing mode combined with nitric oxide inhalation on the rehabilitation outcomes of patients undergoing lung surgery,focusing on pulmonary function,recovery speed,and overall treatment *** A total of 79 patients who underwent lung surgery at a tertiary hospital from March 2021 to December 2021 were divided into a control group(n=39)receiving a routine nursing program and an experimental group(n=40)receiving additional humanized nursing interventions and atomized inhalation of nitric *** indicators were compared between the two groups alongside an analysis of treatment *** The experimental group demonstrated significant improvements in pulmonary function,reduced average recovery time,and lower total treatment costs compared to the control ***,the quality of life in the experimental group was significantly better in the 3 months post-surgery,indicating a more effective rehabilitation *** The combination of humanized nursing mode and nitric oxide inhalation in postoperative care for lung surgery patients significantly enhances pulmonary rehabilitation outcomes,accelerates recovery,and reduces economic *** approach offers a promising reference for improving patient care and rehabilitation efficiency following lung surgery.

关键词： Humanized nursing Nitric oxide Lung segment surgery Rehabilitation Pulmonary function

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