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Objective To evaluate the relationship of preoperative neutrophil-lymphocyte ratio (NLR) with clinicopathological features and prognosis of colorectal cancer in middle-aged and elderly patients.Methods A retrospective analysis was performed in 212 patients with colorectal cancer in the First Affiliated Hospital of Nanjing Medical University from January 2011 to June 2013.All patients were divided into middle-aged group (46-65 year old,n=130) and old-aged group (66-89 year old,n=82),The optimal cut-off point of NLR was identified by the area under receiver operating characteristic curve,while NLR ＞ 3.13 and NLR≤3.13 were classified as high and low NLR group.The clinicopathological features and prognosis between the two groups were compared.Results There was no difference in gender,tumor growth site,depth of invasion,tumor embolus,lymphatic metastasis,distant metastasis,TNM stage between low and high NLR group (allP＞ 0.05).However,the difference between high NLR group and low NLR group in old-aged group with diabetes mellitus was statistically significant (P＜0.05).The 1-,2-,and 3-year survival rate of the overall 212 patients were 96.2％ (204/212),87.7％ (186/212) and 74.5％ (158/212) In middle-aged group,the 1-,2-,and 3-year survival rates were 98.8％ (85/86),90.7％ (78/86) and 84.9％ (73/86) respectively in low NLR group,but 95.5％ (42/44),84.1％ (37/44) and 72.7％ (32/44) respectively in high NLR group,(allP＜0.05).In old-aged group,the 1-,2-,and 3-year survival rates were 95.7％ (44/46),89.1％ (41/46) and 73.9％ (34/46) respectively in low NLR group,but 91.7％ (33/ 36),83.3％ (30/36) and 52.8％ (19/36) respectively in high NLR group (all P＜0.05).Cox regression showed that TNM stage and NLR were independent risk factors for the prognosis of the middle-aged and elderly patients with colorectal cancer (P＜0.05 or P＜0.01).Conclusions Preoperative NLR ＞ 3.13 suggest that the prognosis is poor in middle-aged and elderly patients with colorectal cancer.
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Objective To evaluate the clinical application of enteral nutrition by nasojejunal tube insertion and by percutaneous endoscopic gastrostomy (PEG) in elderly patients.Methods A total of 65 elderly patients with dysphagia recruited at our department from January 2010 to November 2014 were divided into the nasojejunal tube feeding group (35 cases) and the PEG feeding group (30 cases).Differences between these two groups in nutritional indexes,immunological indexes,complications and mortality were analyzed retrospectively.Results Serum total protein,albumin and prealbumin and upper arm circumferences all increased after treatment with nasojejunal tube feeding or percutaneous endoscopic gastrostomy (P＞0.05).There was overall improvement in nutritional status,as assessed by Nutritional Risk Screening 2002 (NRS2002).Specifically,the before/one month-after-treatment ratio of scores was 3.72±0.91/1.90±0.61 (t=7.24,P＜0.01) for the nasojejunal tube feeding group and 3.52±1.23/2.02±0.53 (t=4.17,P＜0.01) for the PEG feeding group.Compared with NRS2002 scores at one month post-operation,further improvement was achieved at 3 months postoperation both for the nasojejunal tube feeding group (1.89±0.65,t=5.21,P＜0.01) and for the PEG feeding group (1.91±0.62,t=4.40,P＜0.01).There was no difference in the indexes of nutrition,immune status or mortality between the two groups (P＞0.05).Although improvement in CD3+,CD4+,CD8+,CD4+/CD8+,IgA,IgG,and IgM was seen in both groups after operation,the differences did not reach statistical significance (P＞0.05).The incidence of aspiration pneumonia was notably lower (P＜0.05) while the incidence of diarrhea was much higher (P＜0.05) in the nasojejunal tube feeding group than in the PEG feeding group at one month and three months.The two groups had similar causes of death and mortality rates.Conclusion Both nasojejunal tube and PEG feeding can improve the nutritional status of elderly patients with dysphagia.However,the choice for the route of nutrition should be individualized.
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Objective Our purpose is to explore the occurrence and distribution of glutamate and metabotropic glutamate receptor in earthworm, P. aspergillum and to analyze their function significance. Methods By employing immunocytochemistry tchnique, the positive cells of glutamate and metabotropic glutamate receptor, mGluR1, mGluR2/3, mGluR4 in earthworm, P. aspergillum were investigated under a light microscope. Results It was found that glutamate positive cells existed in cerebroganglion, subpharyngeal ganglion, ventral ganglion, neurons between muscle cells,intestinal epithelium and epidermis, that thin and dense glutamate positive fibers distributed in pharyngeal nerve cycle, subpharyngeal ganglion, ventral neurochain, that mGluR1 or mGluR4 positive neurons were detected in cerebroganglion and mGluR2/3 positive neurons weren't observed in earthworm. Conclusion During glutamate positive neurons, some possess remarkable processes and matured appearance from which glutamate positive fibers in pharyngeal nerve cycle, subpharyngeal ganglion, ventral neurochain derive, another have few branches, unmatured appearance in which glutamate doesn't serve as neurotransmitter acting to mGluR1 or mGluR4 of neurons in earthworm cerebroganglion.
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Objective\ The adrenal gland is a linkage between nervous system and endocrine system.Its cortex results from mesoderm,and medulla derives from neuroectoderm.Searching its double characteristic of nervous and endocrine tissue is our aim. Methods\ Histochemical and immunohistochemical staining techniques were used,and immunostained sections were observed under a light microscopy. Results\ NPY positive neuron and nerve fiber,CGRP positive nerve fiber existed in adrenal cortex.NADPH d positive neuron and nerve fiber, c fos positive neuron and nerve fiber,CGRP positive nerve fiber,SP positive nerve fiber were detected in adrenal medulla.NADPH d positive cell,NPY positive cell,CGRP positive cell,SP positive cell were found among the adrenal chromaffin cells.The zona glomerulosa,zone fasciculata and zona reticularis were stained strongly by NADPH d in cortex. Conclusion\ The adrenal gland was innervated by NO ergic,NPY ergic,CGRP ergic,SP ergic, c fos ergic nerves.The adrenal parenchyma,especially chromaffin cells can produce NO,NPY,CGRP,SP which regulate adrenal endocrine by itself.The nervous control of adrenal function and neuroendocrine function of adrenal gland is more complex than hitherto believed.\;