Abstract:Inflammatory aneurysms are related to arterial inflammation, and are mainly caused by rheumatic immune diseases. The etiological and differential diagnoses of inflammatory aneurysms are particularly important due to its low incidence, hidden manifestations and different treatment methods from aneurysms caused by atherosclerosis and trauma. Young patients with aneurysms have nonspecific manifestations (such as fever, anemia, fatigue, weight loss) and increased clinical inflammatory indexes (such as erythrocyte sedimentation rate and C reactive protein) should be considered to have high possibility of inflammatory aneurysms. This paper introduces the concept and incidence of rheumatic immune diseases complicated with inflammatory aneurysms, hoping to provide reference for clinicians.

Abstract:Objective To compare the prognostic significance of follicular lymphoma international prognostic index (FLIPI) and FLIPI2 for follicular lymphoma (FL). Methods The clinical data of 107 newly diagnosed FL patients who were admitted to the Department of Hematology, Changhai Hospital, Naval Medical University (Second Military Medical University) from Nov. 16, 2007 to Jun. 1, 2019 were collected, of which 52 patients received rituximab combined chemotherapy and 55 patients received chemotherapy alone. All patients were stratified according to FLIPI and FLIPI2 scores, and the progress-free survival (PFS) rate was analyzed. Results The median age of the 107 FL patients was 53 (25-77) years. The 3- and 5-year PFS rates of the 107 patients were 83.8% and 74.9%, respectively. According to FLIPI scores, the 5-year PFS rates of low-risk (score 0-1), intermediate-risk (score 2), and high-risk (score ≥ 3) groups were 91.7%, 72.0%, and 50.4%, respectively (χ²=14.274, P<0.001); according to FLIPI2 scores, the 5-year PFS rates of low-risk (score 0-1), intermediate-risk (score 2), and high-risk (score ≥ 3) groups were 86.8%, 64.4%, and 39.0%, respectively (χ²=16.675, P<0.001). In the rituximab combined chemotherapy group, there was significant difference in the 5-year PFS rate according to the FLIPI2 prognostic scoring model (χ²=21.597, P<0.01). In the chemotherapy alone group, according to the FLIPI prognostic scoring model, the difference in 5-year PFS rate was significant (χ²=11.982, P=0.003). The 5-year PFS rates of low-, intermediate- and high-risk groups had significant differences for patients aged ≤ 60 years according to FLIPI and FLIPI2 scores (all P<0.01). In the group with rituximab combined chemotherapy and age ≤ 60 years, FLIPI2 performed well in risk stratification for FL patients, and the 5-year PFS rates of patients in the low-, intermediate- and high-risk groups were 95.2%, 87.5% and 50.0%, respectively (χ²=13.989, P<0.001). Conclusion FLIPI2 performs better in risk stratification for FL patients than FLIPI in the era of rituximab. Age is no longer a prognostic factor affecting PFS in FL patients.

Abstract:Objective To study the expression of sex-determining region Y-box 4 (SOX4) in hepatocellular carcinoma (HCC) and its relationship with clinicopathological features and prognosis of HCC. Methods The differential expression of SOX4 in HCC was studied through analying and mining the public database of tumor genes by bioinformatics method, and the relationship between SOX4 expression and clinicopathological characteristics was analyzed; the relationship between SOX4 expression and prognosis of HCC patients was analyzed by Kaplan-Meier method; and SOX4-related biological processes and signal pathways in HCC were explored by Gene Set Enrichment Analysis (GSEA). Results The expression level of SOX4 mRNA in HCC tissues was significantly higher than that in the adjacent tissues (P<0.01), and was significantly correlated with tumor stage and tumor size (P<0.01, P<0.05). The overall survival and recurrence-free survival of HCC patients in SOX4 low-expression group were longer than those of patients in SOX4 high-expression group (both P<0.01), and showed the same prognostic trend in different stages of HCC. Multivariate Cox regression analysis showed that the expression level of SOX4 was an independent prognostic factor of HCC patients (P<0.01). SOX4 played an oncogenic role in HCC by regulating DNA replication, inositol-requiring enzyme 1 (IRE1)-mediated unfolded protein response, mitotic cell cycle arrest, tumor protein p53 activity, Wnt signaling pathways and so on. Conclusion The expression of SOX4 is increased in HCC tissues, and is related to poor prognosis.

Abstract:Objective To investigate the effect of postoperative adjuvant radiotherapy on the prognosis of patients with advanced gastric signet ring cell carcinoma. Methods The data of 1 694 patients with advanced gastric signet ring cell carcinoma were collected from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. The patients were divided into 2 groups, with or without postoperative radiotherapy. Kaplan-Meier method was used to analyze the survival of patients in the 2 groups. Log-rank test and Cox regression were used for survival analysis and subgroup analysis. Results Kaplan-Meier survival curves showed that the prognosis of patients with postoperative radiotherapy was better than that without postoperative radiotherapy group (P<0.05). Log-rank univariate analysis showed that age, race, marital status, TNM stage, T stage, N stage, primary tumor location, maximum tumor diameter, whether to receive chemotherapy or not and whether to receive postoperative radiotherapy or not were the prognostic factors for advanced gastric signet ring cell carcinoma patients (all P<0.01). Multivariate Cox regression analysis showed that age, tumor T and N stages, maximum tumor diameter, whether to receive chemotherapy or not and whether to receive postoperative radiotherapy or not were independent prognostic factors (all P<0.01). Subgroup analysis showed except for N0 group (P>0.05), patients with age ≤ 70 years and >70 years, different T stages, lymph node metastasis (N1-N3), maximum tumor diameter ≤ 5 cm and >5 cm, receiving chemotherapy and those who did not receive chemotherapy, could benefit from postoperative adjuvant radiotherapy (all P<0.01). Conclusion For advanced gastric signet ring cell carcinoma patients who have received surgery, the prognosis of those with postoperative radiotherapy is better than that without postoperative radiotherapy.

Abstract:Objective To investigate the risk factors of dyspnea in acute coronary syndrome (ACS) patients taking antiplatelet drug ticagrelor after percutaneous coronary intervention (PCI). Methods A combination of retrospective and prospective studies was used. A total of 418 ACS patients taking ticagrelor after PCI in the Department of Cardiovasology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from Jan. 2016 to Nov. 2019 were retrospectively included. According to the incidence of dyspnea, the patients were divided into ticagrelor-related dyspnea group and non-dyspnea group. The clinical and laboratory data were collected and compared. In the prospective study, 367 ACS patients taking ticagrelor after PCI in the Department of Cardiovasology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from Jan. to Aug. 2020 were selected. Based on the results of retrospective study and guidelines, the patients were divided into low low-density lipoprotein-cholesterol (LDL-C) group (LDL-C<2.6 mmol/L) and high LDL-C group (LDL-C ≥ 2.6 mmol/L), The clinical data were compared, and the risk factors of ticagrelor-related dyspnea were further analyzed using multiple logistic regression. Results Of the 418 ACS patients in the retrospective study, 71 (17.0%) had ticagrelor-related dyspnea. The ticagrelor-related dyspnea group had more bleeding events (23.9%[17/71] vs 10.1%[35/347], P=0.001) and higher LDL-C level ([2.54±0.88] mmol/L vs[2.32±0.81] mmol/L, P=0.045) compared with the non-dyspnea group. Multiple logistic regression analysis showed that bleeding events (odds ratio[OR]=3.128, 95% confidence interval[CI]1.613-6.065, P=0.001) and elevated LDL-C (OR=1.451, 95% CI 1.071-1.964, P=0.016) were the risk factors of ticagrelor-related dyspnea. Of the 367 ACS patients in the prospective study, 64 (17.4%) had ticagrelor-related dyspnea. The incidence of ticagrelor-related dyspnea was higher in the high LDL-C group than that in the low LDL-C group (23.4%[33/141] vs 13.7%[31/226], P=0.018). At the same time, there were significant differences in the history of smoking, PCI and myocardial infarction, the levels of hypersensitive C reactive protein, fasting blood glucose, total cholesterol, total triglyceride, high-density lipoprotein-cholesterol, left ventricular ejection fraction, and the number of stent implantation between the 2 groups (all P<0.05). Multiple logistic regression analysis showed that smoking history was an independent predictor of ticagrelor-related dyspnea (OR=2.695, 95% CI 1.236-5.878, P=0.013). Conclusion The incidence of dyspnea in ACS patients taking ticagrelor after PCI is 17.4% (64/367). The ACS patients after PCI with serum LDL-C ≥ 2.6 mmol/L are prone to ticagrelor-related dyspnea. Smoking history is an independent predictor of ticagrelor-related dyspnea.

Abstract:Objective To analyze the perioperative use of tramadol in patients undergoing meniscus surgery, so as to provide reference for subsequent rational drug use. Methods The data of 126 patients who underwent arthroscopic meniscus surgery in our hospital from Dec. 2018 to Oct. 2019 were analyzed retrospectively. According to whether tramadol was taken within 1 month before surgery, the patients were divided into tramadol group (n=33) and non-tramadol group (n=93). The general data, the use of tramadol during perioperative period and the occurrence of adverse drug reactions during follow-up were statistically analyzed. Results There were no significant differences in age, gender, body mass index, first clinical diagnosis, anesthesia methods, operation time, operation methods or perioperative non-steroidal anti-inflammatory drug (NSAID) usage between the 2 groups (all P>0.05). Compared with the non-tramadol group, patients in the tramadol group had a risk of continuing drug use 3 and 6 months after surgery (odds ratio[OR]=3.294, 95% confidence interval[CI]1.383-7.846; OR=2.795, 95% CI 1.037-7.534). One month after the operation, among the 29 patients who received meniscus operation alone, the continuous use rate of tramadol was 100.0% (8/8) in the tramadol group and 76.2% (16/21) in the non-tramadol group, with no significant difference (P=0.129); the use rate of tramadol was 90.5% (67/74) in 74 patients receiving less than 3 knee surgery procedures, and 100.0% (52/52) in 52 patients receiving no less than 3 knee surgery procedures, with significant difference (P=0.022). The prescription dose of tramadol in the tramadol group within 1 month after surgery was higher than that in the non-tramadol group (P=0.004), but there was no significant difference in the prescription dose of tramadol between the 2 groups within 3 or 6 months after surgery (both P>0.05). The overall incidence of adverse drug reactions in patients was 11.9% (15/126) during follow-up period, and the incidence of gastrointestinal distress was higher in the tramadol group than that in the non-tramadol group (21.2%[7/33] vs 2.2%[2/93]), with significant difference (P=0.001). The incidence rates of gastrointestinal distress, peptic ulcer, allergy or other adverse drug reactions in patients taking tramadol and NSAIDs at the same time were slightly higher than those in patients taking NSAIDs alone, but with no significant differences (all P>0.05). Conclusion Patients who used tramadol preoperatively have a higher risk of reusing tramadol within 1 month of surgery compared with non-users. Patients receiving more intraoperative procedures during knee arthroscopy may rely more on tramadol for postoperative analgesia, but long-term use of tramadol may lead to adverse drug reactions such as gastrointestinal distress.

Abstract:Objective To study the changes of divers' job performance after simulating long-time underwater transport. Methods The long-time underwater transport environment was simulated in the water cabin. The changes of attention, memory, and abilities of emotional regulation, thinking, visual response, tactile response and manual operation were measured at different time points (0.5, 1, 2, 3, 4 and 5 h) with ergonomic tools. Results After stimulating long-time underwater transport, the job performance indexes tested above were all decreased to varying degrees. The overall descent was not obvious within the first 3 h, while it was significantly decreased and showed an accelerated downward trend after simulating long-time underwater transport for 3 h and more, showing significant difference when compared with 0.5 h of simulating long-time underwater transport (all P<0.01). Conclusion Job performance is gradually decreased in divers during simulating long-time underwater transport, and 3-h underwater transport is the limit for current conditions.

Abstract:Objective To establish a new screening system for protein-protein interaction using BioID combined with mass spectrometry, and to verify the interacting protein of Yes-associated protein 1 (YAP1) through co-immunoprecipitation and Western blotting. Methods The YAP1-BirA^* fusionexpression plasmid was constructed. After the plasmid was transfected into 293T cells, 50 μmol/L biotin was added to the cell culture medium, and the total proteins of the cells were extracted after 24 h of culture. The expression of YAP1-BirA^* fusionprotein was detected by Western blotting with YAP1 specific antibody. Horseradish peroxidase (HRP)-avidin was used to detect the level of proteins labeled by biotin in cells. The biotin-labeled proteins in cells were purified through affinity magnetic beads, and the proteins purified by affinity magnetic beads were dissolved after washing the nonspecific binding proteins on affinity magnetic beads for many times. A total of 40 μg total proteins were subjected to sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), and then the proteins in the gel were stained by protein silver staining kit to determine the purification effect of affinity magnetic beads on biotinylated protein. Biotinylated proteins were identified by label-free mass spectrometry. For the identified proteins, the biotinylation of SMAD family member 3 (SMAD3) was verified by Western blotting. The interaction between SMAD3 and YAP1 was determined by co-immunoprecipitation and Western blotting. Results The YAP1-BirA^* fusionexpression plasmid was successfully constructed, which could efficiently expressed the fusion protein in 293T cells. In the presence of biotin, YAP1-BirA^* fusionprotein could biotin-label the proximity proteins close to YAP1-BirA^* fusionprotein in cells. After cell lysis, these biotin-labeled proteins in cells could be purified by magnetic beads coupled with avidin. After repeated washing, biotin-labeled proteins could be enriched. Mass spectrometry showed that the proteins close to YAP1 in space could be obtained. The interaction between SMAD3 and YAP1 was confirmed by co-immunoprecipitation and Western blotting. Conclusion BioID combined with mass spectrometry is a simple and efficient technology for protein-protein interaction screening. Combined with co-immunoprecipitation and Western blotting, it may become a new protein-protein interaction research system.

Abstract:Objective To observe the therapeutic effect of a small dose of sirolimus-based quadruple immunosuppressive regimen for the treatment of renal allograft dysfunction. Methods Totally 59 patients (44 males and 15 females) with renal allograft dysfunction treated with triple immunosuppressants (mycophenolic acid/mizoribine+calcineurin inhibitors[CNIs]+glucocorticoids) were selected. While the dose of CNIs was reduced, a small dose of sirolimus (initial dose 0.5 mg/d, target blood concentration 2-4 ng/mL) was added so as to convert to the quadruple immunosuppressive regimen. The changes of the blood concentrations of sirolimus and CNIs were recorded, and the indexes of the serum creatinine and blood lipid were analyzed before and after conversion. Results All the 59 patients completed the conversion of quadruple therapy, and the blood concentration of sirolimus was (4.74±1.62) ng/mL; and the blood concentration of CNIs was decreased by (37.00±19.00)% in 53 cases. After adjustment of treatment, serum creatinine level was significantly decreased ([111.53±24.87] μmol/L vs[148.88±27.64] μmol/L, P<0.01). No significant changes were found for the triglyceride ([1.93±1.08] mmol/L vs[1.89±0.77] mmol/L, P>0.05) or cholesterol ([5.30±1.39] mmol/L vs[4.96±1.19] mmol/L, P>0.05). The 59 patients were divided into early conversion group (conversion to quadruple therapy within 1-23 months after renal transplantation, n=44) and late conversion group (conversion to quadruple therapy within 32-159 months after operation, n=15). The proportion of patients with normal renal function in the early conversion group was significantly higher than that in the late conversion group (77.27%[34/44] vs 40.00%[6/15], P<0.05); and the serum creatinine level in the early conversion group was significantly lower than that before conversion ([106.41±19.78] μmol/L vs[151.43±28.68] μmol/L, P<0.05), while no significant decrease was noticed in the late conversion group ([126.53±32.18] μmol/L vs[141.40±24.76] μmol/L, P>0.05). Conclusion Reducing CNIs, while adding a small dose of sirolimus, can significantly improve renal allograft dysfunction after renal transplantation, without increasing the adverse reactions of dyslipidemia. A small dose of sirolimus-based quadruple immunosuppressive therapy is more effective in patients with early postoperative renal allograft dysfunction.

Abstract:Objective To reveal the research focus and frontiers of translational medicine at home and abroad, so as to provide references for relevant domestic institutions to carry out translational medicine research. Methods Based on bibliometrics, themes "translational medicine" (in English or in Chinese) was searched in Web of Science and CNKI to retrieve the related literatures from 2001 to 2020. CiteSpace and VOSviewer softwares were used for quantitative analysis. Results The research focuses of translational medicine at home and abroad were relatively consistent, mainly including 5 aspects:translational medicine concept and development model, tumor diagnosis and precision treatment, stem cell translational research, 3D bioprinting and tissue engineering, and precision medicine and genomics. 3D bioprinting and tissue engineering and omics data analysis have become new research trends. The research abroad were mainly original research focusing on tumors, stem cells, tissue engineering and genomics, while the research in China were mostly review focusing on the translational medicine disciplines construction and talents training, translational medicine platform construction and collaboration mechanism and so on. Conclusion There are abundant research achievements related to translational medicine at home and abroad; however, for the overall development trend, there is still a gap between China and foreign countries on the development level. With the development of advanced technologies such as precision medicine and big data analysis, resource integration and multi-institutional collaborations should be strengthened translational medicine research in our country with the assistant of innovative technologies; technology transformation should be accelerated, and the bridge between bench and bedside should be built.

Abstract:Stromal interaction molecule 1 (STIM1) is a recently discovered Ca²⁺ receptor located on the membrane of endoplasmic reticulum, and it is a transmembrane protein related to cellular Ca²⁺ influx. As an important regulatory protein in the process of store-operated Ca²⁺ entry, STIM1 plays an essential role in Ca²⁺ homeostasis of non-excited cell. To date, domestic and foreign studies have confirmed that STIM1 plays an important role in the development and progression of various diseases such as tumor, inflammation and immunity. This article summarizes the latest research progress of STIM1 in digestive diseases, and briefly describes its potential basic research and clinical value.

Abstract:Spinal cord injury has attracted much attention in clinical treatment. As a traumatic disease of central nervous system with high disability rate, spinal cord injury can lead to severe motor, sensory and autonomic dysfunction. And no satisfactory treatment has been found so far. As a physical therapy, low-intensity pulsed ultrasound (LIPUS) can transfer energy non-invasively and has been applied in fracture healing, muscle injury and tissue repair. Experimental studies have found that LIPUS could play an important role in spinal cord injury, and some studies have explored its mechanism in cytology and molecular biology. The research progress was reviewed in this paper.

Abstract:With the popularization of chest computed tomography (CT) screening, the detection rates of pulmonary peripheral lesions and mediastinal masses have been greatly increased. Novel technologies are emerging to improve the diagnostic rate of traditional bronchoscopy. Endobronchial ultrasound (EBUS) is a minimally invasive diagnosis and treatment technology combining bronchoscopy and ultrasound. It can provide ultrasound images and guide biopsy of airway wall and adjacent structures of bronchial tree in real time. The main types include convex probe-endobronchial ultrasound (CP-EBUS) and radial probe-endobronchial ultrasound (RP-EBUS). CP-EBUS is mainly used in the major airway and central lung lesions, and plays an important role in mediastinal staging of lung cancer. RP-EBUS comprehensive guidance technology is mainly used in the diagnosis of peripheral lung lesions. In addition, EBUS can also be applied to the minimally invasive diagnosis and treatment of some extrapulmonary adjacent organ diseases. With the advantages of low risk, high sensitivity to benign and malignant lesions and good repeatability, EBUS has been widely used in clinical practice all over the world. This paper reviews the development history, clinical application and progress of EBUS.

Abstract:The incidence and detection rate of caesarean scar pregnancy (CSP) after caesarean section have been increasing year by year with the second child policy, advances in imaging diagnostic techniques and the persistently high rate of caesarean section in China. CSP can lead to a series of serious complications that even endanger the lives of pregnant women. Accurate diagnosis and timely treatment will effectively reduce the incidence of complications, save the lives of pregnant women, and preserve female fertility. Magnetic resonance imaging (MRI) has many advantages in the diagnosis of CSP. It can not only achieve accurate diagnosis, but also guide clinical treatment by MRI classification. This article reviews the MRI diagnostic value and research progress of CSP.

Abstract:Military personnel in high-risk mission may experience acute stress reaction and temporary functional damage, which not only endangers the safety of the whole team, but also easily leads to the failure of combat mission. However, the mental health team engaged in combat stress control is far away from the combat mission scene, so it is challenging to provide immediate psychological first aid (PFA). To address this gap, the Israel Defense Forces developed a 5-step intervention (YaHaLOM), which allows ordinary soldiers to provide immediate PFA to the wounded at the scene of combat missions. YaHaLOM is based on the Six Cs (6Cs) model, which stimulate the cognitive communication and shifting the sense of helplessness and passivity to a sense of active and effective functioning among the wounded. YaHaLOM has the advantages of simple and straightforward operation and low training cost, and its effectiveness has also been preliminarily verified, which has a particular enlightening effect on combat stress control of our army.

Abstract:Objective To evaluate the efficacy and safety of dapagliflozin in the treatment of diabetic kidney disease (DKD) in the real world. Methods A total of 84 DKD patients who received dapagliflozin in our hospital from Jan. 2018 to May 2020 and who were followed up for more than 12 months were selected. The effects of dapagliflozin on blood glucose, blood pressure, body weight, blood lipid, proteinuria and renal function of DKD patients were analyzed retrospectively, the differences of clinical outcomes before and after treatment were compared, and the adverse reactions during treatment were recorded. Results Of the 84 patients, the average age was (52.47±8.87) years and 56 cases (66.7%) were males. The diabetes history was 8 (3, 17) years, 35 cases (41.7%) had obesity and overweight, 47 cases (56.0%) had diabetic retinopathy, 69 cases (82.1%) had hypertension, the 24-h urinary protein level was 3 100 (700, 9 100) mg, and the estimated glomerular filtration rate (eGFR) was 87.1 (49.7, 108.2) mL/(min·1.73 m²). During the follow-up period, 12 cases (14.3%) stopped dapagliflozin (4 males and 8 females). Females were more prone to urinary tract infections (17.9%[5/28]vs 1.8%[1/56]; odds ratio[OR]=11.96, 95% confidence interval[CI]1.32-108.07, P=0.007). After 12 months of follow-up, body weight (P=0.02), body mass index (BMI) (P=0.02), systolic blood pressure (P=0.04), total daily insulin dosage (P<0.01), fasting blood glucose (P<0.01), the glycated hemoglobin (P<0.01), and 24-h urinary protein level (P=0.05) were significantly decreased. Conclusion Based on the real-world observational data, dapagliflozin is a relatively safe and effective drug for DKD.

Abstract:Objective To investigate the clinical characteristics, treatment and outcomes of herpes simplex virus encephalitis-induced anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis in children. Methods The clinical data of 3 children with herpes simplex virus encephalitis-induced anti-NMDAR encephalitis treated in our department were collected, including 2 males and 1 female, aged 21 months, 10 years and 4 years, respectively. Results All the 3 children began with convulsion, accompanied by altered consciousness and abnormal behavior. Herpes simplex virus typeⅠ in cerebrospinal fluid was tested positive in all 3 cases. After antiviral and symptomatic treatment, the condition of 3 children was improved, but was aggravated again after 1 week to 1 month, with positive cerebrospinal fluid anti-NMDAR antibodies. After active symptomatic treatment, 2 children recovered well, and 1 gave up treatment and died. Conclusion Herpes simplex virus encephalitis can develop anti-NMDAR encephalitis. Dynamic detection of anti-NMDAR antibody is helpful to early identify the occurrence of autoimmune encephalitis after herpes simplex virus encephalitis, so as to intervene early.

Abstract:Objective To explore the safe time limit of apneic anesthesia with intermittent ventilation (AAIV) for children receiving resection of laryngeal papillomatosis. Methods The anesthesia records of 27 children diagnosed with laryngeal papillomatosis and underwent surgery with AAIV in our hospital from 2015 to 2019 were analyzed retrospectively. The data of gender, age, disease diagnosis, body weight, height, hemoglobin level, anesthesia time, operation time, and recovery time were obtained from the medical records, and the theoretical calculation model was constructed to calculate the theoretical safe time limit and CO₂ accumulation. The results were compared with the existing literatures. Results No serious complications such as severe hypoxia and delayed recovery were recorded during anesthesia and resuscitation, and the perioperative vital signs were stable in all patients. According to the calculation, the theoretical apnea time limit was 247-360 s (4.12-6.00 min) in the model patient, and the theoretical partial pressure of carbon dioxide at end-trial (P_ETCO₂) reached 74.26 mmHg (1 mmHg=0.133 kPa). The average time limit of apnea in the retrieved literatures was 224-292 s (3.73-4.87 min), and the average arterial partial pressure of carbon dioxide (PaCO₂) or P_ETCO₂ was within 70 mmHg. The calculated data of the model were close to the clinical experience data reported in the existing literatures but not completely consistent. Conclusion AAIV for laryngeal papilloma removal in children has corresponding theoretical evidence. However, in practical applications, for children with dysplasia, respiratory tract infections or other diseases which can affect the lung reserve function, it is recommended to take reduction of pulse oxygen saturation (SpO₂) to 95% as an indication to restore ventilation, and we always need to pay attention to CO₂ accumulation.

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