The molecular mechanism of nasopharyngeal carcinoma (NPC) is poorly understood and effective therapeutic approaches are needed. This research aimed to excavate the attractor modules involved in the progression of NPC and provide further understanding of the underlying mechanism of NPC. Based on the gene expression data of NPC, two specific protein-protein interaction networks for NPC and control conditions were re-weighted using Pearson correlation coefficient. Then, a systematic tracking of candidate modules was conducted on the re-weighted networks via cliques algorithm, and a total of 19 and 38 modules were separately identified from NPC and control networks, respectively. Among them, 8 pairs of modules with similar gene composition were selected, and 2 attractor modules were identified via the attract method. Functional analysis indicated that these two attractor modules participate in one common bioprocess of cell division. Based on the strategy of integrating systemic module inference with the attract method, we successfully identified 2 attractor modules. These attractor modules might play important roles in the molecular pathogenesis of NPC via affecting the bioprocess of cell division in a conjunct way. Further research is needed to explore the correlations between cell division and NPC.

ABSTRACT Objective: The study aimed to evaluate the influence of repeated recruitment manoeuvres (RRMs) on lung injury in patients with acute respiratory distress syndrome (ARDS). Methods: Forty-one ventilated patients with severe ARDS were selected for this study. Recruitment manoeuvres (RMs) were conducted with continuous positive airway pressure (CPAP; 30 cm H2O for 40 seconds). Recruitment manoeuvres were repeated every two hours for all three groups. Changes in haemodynamics, pulmonary compliance, gas exchange and extravascular lung water index (EVLWI) were monitored before RM (pre-RM), 10 minutes after each RM, and four hours after RM3 (4 hours post-RRM). Pulmonary inflammatory factors (tumour necrosis factor-alpha [TNF-α] and interleukin [IL]-6 and −10) were also analysed. Results: Compared with those in pre-RM, pulmonary compliance, oxygenation index (ratio of partial pressure of arterial oxygen to fraction of inspired oxygen [PaO2/FiO2]) and EVLWI remarkably improved in RM1, RM2, RM3 and 4 hours post-RRM (p < 0.05). The PaO2/FiO2 ratio increased significantly in RM1 and RM3 (p < 0.05). Extravascular lung water index decreased significantly in RM1 compared with that in RM3 and 4 hours post-RRM (p < 0.05). There was no significant difference in cytokines. Conclusion: Repeated recruitment manoeuvres during lung-protected ventilation can improve pulmonary compliance and oxygenation and significantly decrease extravascular lung water in ARDS patients. Lung injury was not worsened by RRMs in patients with severe ARDS.

RESUMEN Objetivo: El estudio tuvo por objeto evaluar la influencia de las maniobras de reclutamiento repetidas (MRR) en la lesión pulmonar en pacientes con síndrome de dificultad respiratoria agudo (SDRA). Métodos: Para este estudio se seleccionaron cuarenta y un pacientes ventilados, con SDRA severo. Se realizaron maniobras de reclutamiento (MR) con presión positiva continua de las vías respiratorias (CPAP; 30 cm H2O durante 40 segundos). Las maniobras de reclutamiento se repitieron cada dos horas para los tres grupos. Los cambios de hemodinámica, distensibilidad pulmonar, intercambio gaseoso e índice de agua pulmonar extravascular (EVLWI) fueron monitoreados antes de MR (pre-MR), diez minutos después de cada MR y cuatro horas después de MR3 (4 horas post-MRR). También se analizaron los factores de inflamación pulmonar: factor de necrosis tumoral alfa, e interleucina-6 y-10 (TNF-α, IL-6 e IL-10). Resultados: En comparación con los de pre-MR, la distensibilidad pulmonar, el índice de oxigenación, la proporción de la presión parcial de oxígeno arterial con respecto a la fracción de oxígeno inspirado (PaO2/FiO2) y EVLWI mejoraron notablemente en MR1, MR2, MR3, y cuatro horas post-MRR (p < 0.05). La razón PaO2/FiO2 aumentó significativamente en MR1 y MR3 (p < 0.05). El índice de agua pulmonar extravascular disminuyó significativamente en MR1, en comparación con la de MR3 y cuatro horas de post-MRR (p < 0.05). No hubo diferencias significativas en las citocinas. Conclusión: Las maniobras de reclutamiento repetidas durante la ventilación de protección pulmonar puede mejorar la oxigenación y la distensibilidad pulmonar, y disminuir considerablemente el agua pulmonar extravascular en pacientes con SDRA. La lesión pulmonar no fue empeorada por MRR en pacientes con SDRA grave.