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Objective:To investigate the influencing factors and management strategies of colonoscopy-associated colorectal perforation.Methods:The retrospective case-control study was conducted. The clinical data of 358 patients who underwent colonoscopy in the Affiliated Hospital of Zunyi Medical University from January 2011 to March 2021 were collected. There were 216 males and 142 females, aged (59±14)years. Patients underwent colonoscopy for diagnosis or treatment. Observation indicators: (1) situations of colonoscopy-associated colorectal perforation; (2) analysis of influencing factors of colonoscopy-associated colorectal perforation; (3) construction of prediction model of colonoscop-associated colorectal perforation; (4) management of colonoscopy-associated colorectal perforation. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was analyzed using the Wilcoxom rank sum test. Count data were discribed as absolute numbers, and comparison between groups was analyzed using the chi-square test. Multivariate ana-lysis was conducted using the binary Logistic regression model. The sensitivity and specificity of the prediction model were evaluated by the receiver operating characteristic (ROC) curve. Results:(1) Situations of colonoscopy-associated colorectal perforation. Of the 358 patients, 18 cases developed colorectal perforation, including 6 males and 12 females, with an age of 61(49,69) years. Of the 18 patients, there were 12 cases with colon perforation, including 10 cases of sigmoid colon perfora-tion or rectosigmoid junction perforation, 1 case of transverse colon perforation and 1 case of descending colon perforation, 6 cases with rectal perforation. There were 11 cases with diagnostic perforation and 7 cases with therapeutic perforation. (2) Analysis of influencing factors of colonoscopy-associated colorectal perforation. Results of univariate analysis showed that gender, age, colorectal ulcer, colorectal diverticulum, colorectal tumor, history of abdominal surgery, type of colonoscopy and the experience of operating physician were related factors for colonoscopy-associated colorectal perforation ( χ2=5.77, Z=?3.24, χ2=37.99, 97.34, 37.99, 10.31, 8.07, 6.73, P<0.05). Results of multi-variate analysis showed that colorectal diverticulum and abdominal surgery history were indepen-dent risk factors for colonoscopy-associated colorectal perforation ( odds ratios=287.79, 6.74, 95% confidence intervals as 23.14?3 579.11, 1.19?38.27, P<0.05). Therapeutic colonoscopy was an independent protective factor for colonoscopy-associated colorectal perforation ( odds ratio=0.11, 95% confidence interval as 0.23?0.52, P<0.05). (3) Construction of prediction model of colonoscopy-associated colorectal perforation. With the colonoscopy-associated colorectal perforation as depen-dent variable, colorectal diverticulum, abdominal surgery history and therapeutic colonoscopy as independent variables, a prediction model of colonoscopy-associated colorectal perforation was constructed. The ROC of model showed that the sensitivity was 0.56, the specificity was 1.00, and the area under curve was 0.78 (95% confidence interval as 0.63?0.92, P<0.05). (4) Management of colonoscopy-associated colorectal perforation. Of the 18 cases with colonoscopy-associated colorectal perforation, 15 cases underwent laparoscopic perforation repair surgery immediately, 2 cases under-went endoscopic suture, and 1 case received conservative treatment. All the patients with perfora-tion were cured and discharged from hospital, without death due to colonoscopy-associated colorectal perforation. Conclusions:Colonoscopy-associated colorectal perforation is easy to occur at sigmoid colon or rectosigmoid junction. Colorectal diverticulum and abdominal surgery history are indepen-dent risk factors for colonoscopy-associated colorectal perforation. Therapeutic enteroscopy is an independent protective factor for colonoscopy-associated colorectal perforation. Laparoscopic repair of colon perforation has good effects for patients with colorectal perforation.
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Objective:To investigate the influence of nonylphenol (NP) on cytoactive and the expression of G protein-coupled estrogen receptor 30 (GPR30) in human colon cancer SW480 cells.Methods:The experimental study was conducted. The human colon cancer SW480 cells were cultured in vitro. The influence of NP on proliferation, cell cycle, apoptosis and the expression of GPR30 in human colon cancer SW480 cells were analyzed by cell proliferation, cell cycle detection, cell apoptosis and gene expression and protein expression experiments. Cell grouping: SW480 cells cultured with medium were set as the control group, cultured with medium+1×10 ?8 mol/L estradiol were set as the estradiol group, cultured with medium+1×10 ?8 mol/L NP were set as the NP group, cultured with medium+1×10 ?8 mol/L NP+1×10 ?7 mol/L GPR30 specific antagonist G15 were set as the NP+G15 group, respectively. Observation indicators: (1) proliferation index of human colon cancer SW480 cells in the 4 groups; (2) cycle proportion of human colon cancer SW480 cells in the 4 groups; (3) apoptosis index of human colon cancer SW480 cells in the 4 groups; (4) GPR30 messenger RNA(mRNA) expression of human colon cancer SW480 cells in the 4 groups; (5) GPR30 protein expression of human colon cancer SW480 cells in the 4 groups. Measurement data with normal distribution were represented as Mean± SD and one way ANOVA was used for comparison between groups. The least significant difference method was used to test the pairwise comparison. Results:(1) Proliferation index of human colon cancer SW480 cells in the 4 groups. Results of the cell proliferation experiments showed that the proliferation indexes of human colon cancer SW480 cells in the control group, the estradiol group, the NP group and the NP+G15 group were 100.00±0.00, 89.19±4.86, 148.96±6.04 and 120.40±3.39, respectively, showing a significant difference among the 4 groups ( F=21.45, P<0.05). There was a significant difference between the control group and the NP group ( P<0.05), and there was no significant difference between the control group and the estradiol group, between the control group and the NP+G15 group ( P>0.05). (2) Cycle proportion of human colon cancer SW480 cells in the 4 groups. Results of the cell cycle detection experiments showed that the proportions of human colon cancer SW480 cells in the S phase of the cell cycles in the control group, the estradiol group, the NP group and the NP+G15 group were 39.96%±2.02%, 36.67%±0.62%, 43.85%±1.02% and 38.29%±1.42%, respectively, showing a significant difference among the 4 groups ( F=10.08, P<0.05). There were significant differences between the control group and the estradiol group, between the control group and the NP group ( P<0.05), and there was no significant difference between the control group and the NP+G15 group ( P>0.05). (3) Apoptosis index of human colon cancer SW480 cells in the 4 groups. Results of the cell apoptosis experiments showed that the apoptosis indexes of human colon cancer SW480 cells in the control group, the estradiol group, the NP group and the NP+G15 group were 1.67±0.18, 4.80±0.31, 0.75±0.11 and 2.20±0.19, respectively, showing a significant difference among the 4 groups ( F=136.79, P<0.05). There were significant differences between the control group and the estradiol group, between the control group and the NP group ( P<0.05), and there was no significant difference between the control group and the NP+G15 group ( P>0.05). (4) GPR30 mRNA expression of human colon cancer SW480 cells in the 4 groups. Results of quantitative real-time polymerase chain reaction detection showed that the relative expression rates of GPR30 mRNA in human colon cancer SW480 cells of the control group, the estradiol group, the NP group and the NP+G15 group were 1.00±0.00, 0.86±0.05, 1.89±0.27 and 0.64±0.12, respectively, showing a significant difference among the 4 groups ( F=26.61, P<0.05). There were significant differences between the control group and the NP group, between the control group and the NP+G15 group ( P<0.05), and there was no significant difference between the control group and the estradiol group ( P>0.05). (5) GPR30 protein expression human colon cancer SW480 cells in the 4 groups. Results of Western blot detection showed that the relative expression rates of GPR30 protein in human colon cancer SW480 cells of the control group, the estradiol group, the NP group and the NP+G15 group were 1.83±0.16, 1.68±0.15, 3.10±0.30 and 1.26±0.11, respectively, showing a significant difference among the 4 groups ( F=34.05, P<0.05). There were significant differences between the control group and the NP group, between the control group and the NP+G15 group ( P<0.05), and there was no significant difference between the control group and the estradiol group ( P>0.05). Conclusion:Low dose of NP can increase the proliferation index and the proportion of cells in the S phase of the cell cycles, decrease the apoptosis index, and promote the mRNA and protein expression of GPR30 in human colon cancer SW480 cells.
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Objective:To investigate the influencing factors for postoperative venous thromboembolism (VTE) of inguinal hernia.Methods:The retrospective case-control study was conducted. The clinical data of 350 patients undergoing surgical treatment of inguinal hernia who were admitted to Affiliated Hospital of Zunyi Medical University from January to December 2017 were collected. There were 287 males and 63 females, aged from 15 to 89 years, with a median age of 57 years. Observation indicators: (1) surgical and postoperative situations; (2) follow-up; (3) analysis of influencing factors for postoperative VTE of inguinal hernia. Follow-up using outpatient examination and telephone interview was performed to detect recurrence and complications of inguinal hernia after patients being discharged from hospital. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed using the nonparametric rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Multivariate analysis was conducted using the binary Logistic regression model. Results:(1) Surgical and postoperative situations: of the 350 patients, 173 underwent open inguinal hernia surgery including 66 cases with plain patch repair, 54 cases with Lichtenstein repair, 30 cases with mesh plug plain patch repair, 23 cases with Bassini repair, and 177 underwent laparoscopic inguinal hernia surgery including 134 cases with laparoscopic transabdominal preperitoneal prothetic repair, 43 cases with laparoscopic totally extraperitoneal prothetic repair. There were 335 of the 350 patients negative for postoperative VTE while 15 patients positive for postoperative VTE. Of the 15 patients who were diagnosed with postoperative VTE, 13 cases underwent open surgery while 2 cases underwent laparoscopic surgery including 1 died; 12 cases were diagnosed with deep vein thrombosis and 3 cases were diagnosed with pulmonary thromboembolism including 1 died. (2) Follow-up: 349 of the 350 patients were followed up for one year after operation. Of the 349 patients, 2 had recurrence of inguinal hernia and 18 had seroma in the operation area within one year. None of the 349 patients had postoperative patch-related infection or incision infection in the operation area. Of the 14 patients who were diagnosed with postoperative VTE, recurrence of inguinal hernia was not observed within one year. (3) Analysis of influencing factors for VTE of inguinal hernia. Results of univariate showed that age, body mass index (BMI), hypertension, type of operation, the compression time of operative area, time to first out-of-bed activities, duration of hospital stay, postoperative Caprini score were influencing factors for postoperative VTE of inguinal hernia ( χ2=13.217, 9.183, 4.388, 8.694, Z=-4.690, -5.265, -4.281, -4.883, P<0.05), and age, cases with chronic bronchitis, the stable stage of chronic obstructive pulmonary disease (COPD) were influencing factors for postoperative VTE of inguinal hernia ( P<0.05). Results of multivariate analysis showed that age≥65 years, BMI≥25.0 kg/m 2, chronic bronchitis, the stable stage of COPD, open surgery, the compression time of operative area≥42 hours, time to first out-of-bed activities≥60 hours, postoperative Caprini score>5 were independent risk factors for postoperative VTE of inguinal hernia ( odds ratio=1.085, 1.320, 0.256, 0.013, 7.874, 1.112, 1.027, 6.909, 95% confidence interval: 1.031-1.141, 1.024-1.702, 0.071-0.929, 0.016-0.800, 1.489-41.630, 1.061-1.165, 1.008-1.047, 3.045-15.678, P<0.05). Conclusions:Age≥65 years, BMI≥25.0 kg/m 2, cases with chronic bronchitis preoperatively, the stable stage of COPD, open surgery, the compression time of operative area≥42 hours, time to first out-of-bed activities≥60 hours, postoperative Caprini score>5 are independent risk factors for postoperative VTE of inguinal hernia.
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Objective:To explore the clinical characteristics, treatment and prognosis of neonatal septicemia caused by Streptococcus agalactiae.Methods:There were 29 cases of neonatal septicemia caused by Streptococcus agalactiae from January 2017 to December 2019 treated at Qingdao Women and Children′s Hospital.These cases were divided into the early-onset group (onset day of the patients ≤7 d) and late-onset group (onset day of the patients>7 d). Clinical data were collected for analysis.Results:The cases included in the current study accounted for 10.8% of all neonatal septicaemia during the same period.There were 23 cases born via vaginal delivery (79.3%) and 6 cases born by cesarean section (20.7%). Eighteen cases (62.1%) had early-onset (≤7 d) sepsis, and eleven cases (37.9%) had late-onset (>7 d) sepsis.The incidence of pneumonia was higher in the early-onset group compared with the late-onset group (83.3% vs.36.4%), while the incidence of purulent meningitis in early-onset group was lower than that in the late-onset group (33.3% vs.81.8%), and the length of hospital stay was shorter in early-onset group[(16.17±9.33)d vs.(36.73±27.43)d]. The differences between two groups were statistically significant (all P<0.05). Peripheral white blood cell counts elevated in 9 (31.0%) cases, and reduced in 15 (51.7%) cases.The levels of C-reactive protein increased in 18 (62.1%) cases, while the early value of procalcitonin increased in all cases.Drug sensitivity test showed that the sensitivity rates to erythromycin, clindamycin and tetracycline were 30.0%, 31.0%, and 24.1%, respectively.All strains were sensitive to penicillin G, ampicillin, vancomycin, linezolid and cefotaxime.A total of 28 cases were treated with two antibiotics.Twenty-two cases (75.9%) were cured, three cases (10.3%) were discharged after improvement, four cases (13.8%) died after abandoning treatment, and one case was left with neurological sequelae. Conclusion:Streptococcus agalactiae is one of the common pathogens of neonatal septicemia.Children with different onset time may have different complications.Decrease in white blood cell counts and elevation of procalcitonin are highly sensitive to neonatal septicaemia caused by Streptococcus agalactiae.Penicillin and/or cephalosporin antibiotics are the first choice in treatment, and the critically ill patients are treated with combination of two antibiotics.
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Objective To establish model of the chicken embryo transplantation of human colon cancer cells ,and investigate the effect of Solanine、VEGF antibody and Solanine combined with VEGF antibody on human colon cancer cells induce tumor angio‐genesis and tumor proliferation .Methods The model of the chicken embryo transplantation of human colon cancer HT‐29 cells were divided into three experimental group and control group .We added to the chick embryo chorioallantoic membrane with Sola‐nine、VEGF antibody and Solanine+ VEGF antibody mixture ,PBS was added to the control group .Then we analysed picture through the stereomicroscope and IPP 6 .0 image analysis software ,using immunohistochemistry envision method to detect of CD34 antigen and ki‐67 antigen ,and observing effect of Solanine group ,VEGF antibody group ,Solanine+ VEGF antibody group and the effect on the tumor angiogenesis and tumor proliferation .Results The tumor angiogenesis ,CD34 antigen and ki‐67 antigen of Sola‐nine+VEGF antibody group were significantly better than those of VEGF antibody group and Solanine group(P<0 .01);VEGF antibody group had statistical significant difference with Solanine group(P<0 .01);the effect of other three groups were better than that of the control group(P<0 .01) .Conclusion Solanine、VEGF antibody and Solanine combined with VEGF antibody could in‐hibit tumor angiogenesis and tumor proliferation of human colon cancer cell line HT‐29 to induce .It provides a new way for anti‐an‐giogenes .