Analysis of factors associated with postoperative acute kidney injury in patients with colorectal cancer / 中华普通外科杂志

Objective:To investigate factors associated with acute kidney injury(AKI) in postoperative colorectal cancer patients.Methods:The clinical data of 376 colorectal carcinoma (CRC) patients at Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University from Jan 2018 to Jun 2021 were retrospectively analyzed. Patients were divided into acute kidney injury (AKI) ( n=29) and non-AKI groups ( n=347). The demographic information, perioperative status, laboratory results and other relevant data of the two groups were compared . Binary logistic regression was used to analyze the independent risk factors for postoperative AKI. Results:Twenty-nine CRC patients (7.7%) had postoperative AKI. Binary Logistic regression analysis showed that preoperative hypertension ( OR=3.487, 95% CI: 1.081-11.251, P=0.037), anemia ( OR=3.158, 95% CI: 1.114-8.953, P=0.031), inadequate intraoperative crystalloid infusion ( OR=0.998, 95% CI: 0.997-0.999, P=0.007), low intraoperative mean arterial pressure ( OR=0.915, 95% CI: 0.863-0.970, P=0.003) and moderate to severe postoperative decline in hemoglobin levels ( OR=4.105, 95% CI: 1.487-11.335, P=0.006) were independent risk factors. Conclusion:Preoperative hypertension, anemia, inadequate intraoperative crystalloid infusion, low intraoperative mean arterial pressure, and moderate to severe postoperative decline in hemoglobin levels were independent risk factors for AKI development in colorectal cancer patients.

Application value of evaluation and management of patients with acute chest pain in China score in risk stratification for patients with acute chest pain / 中国医师进修杂志

Objective:To explore the application value of evaluation and management of patients with acute chest pain in China (EMPACT) score in risk stratification for patients with acute chest pain.Methods:According to the methods of prospective cohort study, 548 patients with chest pain in the Affiliated Hospital of Jining Medical University from February to April 2021 were selected. The risk stratification was performed according to EMPACT score. The primary endpoint was the major adverse events (MAE) within 30 d, including death from all causes, acute myocardial infarction (AMI), emergency revascularization, cardiac arrest, cardiogenic shock and other life-threatening situations that need urgent attention. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of EMPACT score for MAE.Results:Among the 548 patients, 75 cases had MAE within 30 d (MAE group), and the incidence of MAE was 13.7%; 473 cases did not occur MAE (non-MAE group). The EMPACT score in MAE group was significantly higher than that in non-MAE group: 8 (12, 18) scores vs. 5 (2, 8) scores, and there was statistical difference ( Z = 8.94, P<0.01). Spearman correlation analysis result showed that EMPACT score was positively correlated with MAE ( r = 0.38, P<0.01). ROC curve analysis result showed that the area under the curve of EMPACT score in prediction within 30 d MAE was 0.820 (95% CI 0.770 to 0.871), the cut-off value was 9.5 scores (since all the scoring systems were integers, the cut-off value was 10 scores), the sensitivity was 88.6%, and the specificity was 60.0%. Conclusions:The EMPACT score has a good risk stratification capability to achieve safe and effective triage of acute chest pain.

Mutual prediction of peer relationship and internalizing problem of preschool children / 中国学校卫生

Objective@#To investigate the mutual prediction relationship between peer relationship and internalizing problem.@*Methods@#One-year follow up survey was conducted with a sample of 220 preschool children from 4 kindergartens in Shandong province. The quality of peer relationship and degree of internalizing problem were evaluated with the Peer Relationship Scale and the Child Behavior Checklist Cross-lagged panel analysis was used for mutual prediction among variables.@*Results@#The quality of preschool children’s peer relationship showed an increasing trend with grade(F=6.40, 4.81, P<0.01), while the degree of internalizing problem showed a downward trend(F=7.65, 5.46, P<0.01). The predictive effect of pre-test peer relationship and internalizing problem on post-test corresponding behaviors were all statistically significant (β=0.56, 0.49, P<0.01). The predictive effect of pre-test peer relationship on post-test internalizing problem was statistically significant(β=-0.19, P<0.05).@*Conclusion@#Both peer relationship and internalizing problem has a certain stability across time, and early peer relationship and internalizing problem could predict later corresponding behaviors. Early peer relationship can predict later internalizing problem, while early internalizing problem cannot predict later peer relationship.

Association between diabetes and nonalcoholic fatty liver disease-related hepatocellular carcinoma / 临床肝胆病杂志

Hepatocellular carcinoma(HCC) is one of the most common malignant tumors. With the development of antiviral therapy and the changes in lifestyle, the main pathogenic factor of HCC gradually changes from viral hepatitis to nonalcoholic fatty liver disease. Diabetes mellitus is a common chronic disease, and at present, there is an increasing number of patients with both nonalcoholic fatty liver disease and diabetes. Nonalcoholic fatty liver disease and diabetes share some common mechanisms, and diabetes may promote the progression of nonalcoholic fatty liver disease and increase the risk of HCC. This article reviews the association of diabetes and nonalcoholic fatty liver disease with HCC.

Nuclear Factor I/A Controls A-fiber Nociceptor Development / 神经科学通报·英文版

Noxious mechanical information is transmitted through molecularly distinct nociceptors, with pinprick-evoked sharp sensitivity via A-fiber nociceptors marked by developmental expression of the neuropeptide Y receptor 2 (Npy2r) and von Frey filament-evoked punctate pressure information via unmyelinated C fiber nociceptors marked by MrgprD. However, the molecular programs controlling their development are only beginning to be understood. Here we demonstrate that Npy2r-expressing sensory neurons are in fact divided into two groups, based on transient or persistent Npy2r expression. Npy2r-transient neurons are myelinated, likely including A-fiber nociceptors, whereas Npy2r-persistent ones belong to unmyelinated pruriceptors that co-express Nppb. We then showed that the transcription factors NFIA and Runx1 are necessary for the development of Npy2r-transient A-fiber nociceptors and MrgprD C-fiber nociceptors, respectively. Behaviorally, mice with conditional knockout of Nfia, but not Runx1 showed a marked attenuation of pinprick-evoked nocifensive responses. Our studies therefore identify a transcription factor controlling the development of myelinated nociceptors.

Emergency endoscopic treatment in elderly patients with non-varicose upper gastrointestinal bleeding / 中华老年医学杂志

Objective:To investigate endoscopic treatment and its effects on non-varicose upper gastrointestinal bleeding in elderly patients.Methods:From June 2018 to September 2019, 86 elderly patients with non-varicose upper gastrointestinal bleeding treated in our hospital were enrolled and underwent endoscopic hemostasis.They were divided into the observation group(n=45, receiving endoscopic hemostasis combined with somatostatin treatment)and the control group(n=41, only receiving endoscopic hemostasis treatment). Clinical effects were evaluated in the two groups.Results:The immediate hemostasis rate was higher and the rebleeding rate within 1 week was lower in the observation group than in the control group(95.6% or 43/45 vs.80.5% or 33/41, 11.1% or 5/45 vs.29.3% or 12/41, χ2=4.740 and 4.460, P=0.030 and 0.035). Arrhythmias, multiple organ failure, and death during treatment occurred in 1 case, 0 cases, and 0 cases in the observation group and 4 cases, 2 cases, and 1 case in the control group, respectively.The incidence of complications was lower in the observation group than in the control group(2.2% or 1/45 vs.17.1% or 7/41, χ2=5.608, P=0.018). Conclusions:Endoscopic hemostasis combined with somatostatin treatment can not only achieve satisfactory hemostatic effects, but also reduce the incidence of rebleeding in elderly patients with non-varicose upper gastrointestinal hemorrhage, and thus plays an important role in alleviating suffering and ensuring safety in elderly patients.

Clinical application of three-dimensional printing in the treatment of knee varus with high tibial osteotomy / 中华创伤骨科杂志

Objective To evaluate the clinical application of a three-dimensional (3D) printing personalized guide for medial open wedge high tibial osteotomy(MOWHTO) in the treatment of knee varus osteoarthritis.Methods A retrospective study was conducted of the 16 patients with knee varus osteoarthritis who had been treated at Department of Orthopaedics,Zhengzhou Central Hospital of Zhengzhou University from January 2016 to January 2017.They were 6 men and 10 women,aged from 49 to 65 years (mean,55.8 years).Bilateral knees were involved in 2 cases and a unilateral knee was involved in 14 cases.Their disease duration ranged from one to 12 years (mean,5.3 years).A personalized guide for MOWHTO was designed and manufactured by 3D printing for every patient preoperatively.All the patients underwent knee arthroscopy before osteotomy which was assisted by the personalized guide.The femorotibial angle (FTA),medial proximal tibial angle (MPTA),weight bearing line (WBL),posterior tibial slope (PTSA) and the patellofemoral height Insall-Salvati index (IS index) were measured on their X-ray radiographs preoperatively and 6 months postoperatively.The Hospital for Special Surgery (HSS) score and visual analogue scale (VAS) were used to evaluate the outcomes at the final follow-ups.Results All surgeries were successful.The 16 patients were followed up for 6 to 12 months (mean,9.1 months).The FTA,MPTA,WBL and IS index at postoperative 6 months were significantly improved than the preoperative values (P ＜ 0.05).There was no significant difference between postoperative PTSA and preoperative PTSA (P =0.990).The mean VAS scores for the 16 patients at the final follow-ups were 0.8 ± 0.7 peints,significantly better than the preoperative ones (4.2 ± 0.9 points) (P ＜ 0.05);their mean postoperative HSS scores (89.3 ± 6.7 points) were also significantly improved than the preoperative ones (61.9 ± 10.5 points) (P ＜ 0.05).According to the HSS scores at the final follow-ups,the surgical outcomes were excellent in 14 knees,good in 3 and fair in one.Conclusion A 3D printed osteotomy guide can be used to perform precise osteotomy in MOWHTO for knee varus osteoarthritis,leading to effective correction of the alignment of the lower limb and good short-term surgical outcomes.

Detection and clinical significance of myeloid-derived suppressor cells in peripheral blood of patients with rectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the expression of myeloid-derived suppressor cells (MDSC) in peripheral blood of patients with rectal carcinoma and to preliminarily explore its clinical significance.</p><p><b>METHODS</b>Blood samples from 76 rectal carcinoma patients who underwent surgery in Department of General Surgery, The Affiliated Cancer Hospital, Zhengzhou University between June and October 2013 were collected before operation, postoperative day 10 and 2 years after operation respectively. Flow cytometry was used to detect MDSC percentage in peripheral blood of 76 rectal carcinoma patients and 40 healthy people. The change of MDSC percentage in peripheral blood of rectal carcinoma patients after treatment was investigated. Furthermore, the relationship of peripheral blood MDSC percentage with clinicopathological characteristics was examined.</p><p><b>RESULTS</b>Preoperative MDSC percentage in peripheral blood of 76 rectal carcinoma patients [(3.52±0.68)%] was higher than that of 40 healthy people[(0.92±0.21)%], with significant difference (t=3.026, P=0.005). Preoperative MDSC percentage in peripheral blood of rectal carcinoma patients was significantly related with histological classification (t=2.453, P=0.018), depth of tumor invasion (t=2.051, P=0.035), lymph node metastasis (t=2.328, P=0.022), TNM stage (t=2.529, P=0.016). Univariate analysis showed that TNM stage, histological classification, lymph node metastasis, preoperative MDSC percentage in peripheral blood were the prognostic factors in rectal carcinoma. Multivariate analysis showed that TNM stage (HR=2.535, 95%CI: 0.851 to 4.160, P=0.038) and preoperative MDSC percentage in peripheral blood (HR=3.651, 95%CI: 0.877 to 14.263, P=0.031) were independent prognostic factors of rectal carcinoma. MDSC percentage in peripheral blood of rectal carcinoma patients decreased significantly on the postoperative 10-day [(2.41±0.46)%] compared to that before operation [(3.52±0.68)%], whose difference was statistically significant (t=1.778, P=0.043). During follow-up, tumor recurrence or metastasis was found in 23 patients. MDSC percentage in peripheral blood of rectal carcinoma patients with recurrence or metastasis [(4.37±1.23)%] was higher than that of rectal carcinoma patients without recurrence or metastasis [(2.36±0.35)%] two years after operation, with statistically significant difference (t=1.982, P=0.039).</p><p><b>CONCLUSIONS</b>MDSC percentage in peripheral blood of rectal carcinoma patients is significantly elevated compared to that of healthy people. Increased MDSC percentage indicates poor prognosis and tumor progression in rectal carcinoma patients. Measurement of peripheral blood MDSC percentage may have a potential clinical value in prognosis prediction of rectal carcinoma.</p>

Association of C-MET Protein Expression with Survival in Patients with Stage Ⅲ Gastric Cancer:A Retrospective Analysis / 胃肠病学

Background:C-MET is expressed in a variety of tumor,and its expression may help to predict the prognosis of patients with gastric cancer. Aims:To explore the association of C-MET protein expression with survival in patients with stage Ⅲ gastric cancer. Methods:A total of 178 consecutive initially treated patients with stage Ⅲ gastric cancer from April 2010 to April 2014 at Beijing Pinggu Hospital were enrolled in this study. The expression of C-MET protein was determined by immunohistochemistry. Kaplan-Meier method was used to analyze the survival in patients with high C-MET protein expression and low C-MET protein expression,COX proportional hazards model was used to analyze the influence of various factors on prognosis. Results:C-MET protein was low expressed in 139 patients(78. 1%),and high expressed in 39 patients(21. 9%). Median survival(25. 1 months vs. 45. 0 months),1-year survival rate(69. 2% vs. 91. 4%),2-year survival rate(41. 0% vs. 84. 0%)were significantly decreased in high C-MET protein expression group than in low C-MET protein expression group(P all 0. 05). Conclusions:C-MET protein expression rate is 21. 9% in patients with stageⅢgastric cancer,C-MET expression is significantly associated with survival;1-year survival rate is lower in patients with high C-MET protein expression.

Two cases of acute pulmonary embolism in head and neck tumor surgery / 临床耳鼻咽喉头颈外科杂志

A male patient with hypopharyngeal cancer accepted operation under general anesthesia. Sixth day after surgery in patient with sudden chest pain and obvious difficulty in breathing. Blood oxygen saturation of 90%. The electrocardiogram showed: ST-T change,Tv6 flat;blood gas analysis: pH 7. 491, PCO2 34. 1 mmHg, PO2 54. 7 mmHg; D-Dimer 3. 87 mg/L; white blood cell 17. 50 × 10(9)/L. CTPA showed: right pulmonary artery embolism,pulmonary infection. Another male patient with the right tonsil cancer accepted operation under general anesthesia. Fourth day of patient suddenly appear bosom frowsty and obvious difficulty in breathing. Blood oxygen sat- uration of 88%. Blood gas analysis: pH: 7. 48, PCO2 : 33 mmHg, PO2 : 57 mmHg; D-Dimer: 2. 97 mg/L; white blood cell:11. 80 × 10(9)/L. CTPA showed: the main pulmonary artery and right pulmonary artery branch embolism, pulmonary inflammation. Both were diagnosised as acute pulmonary embolism and recovered well after giving anticoagulant therapy in time.

Estrogen receptor-β expression in laryngeal carcinoma: correlation with the expression of epithelial-mesenchymal transition specific biomarkers / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To detect the expression of ERβ in laryngeal carcinoma and the its correlation with the expression of epithelial-mesenchymal transition(EMT) specific biomarkers.@*METHOD@#Picture MT-Pv9000 was used to detect ERβ and EMT in 72 cases of human aqueous laryngeal carcinoma and 8 cases of adjacent non-neoplastic laryngeal mucosa by immunohistochemistry.@*RESULT@#The positive rates of ERβ in tumors and adjacent non-neoplastic laryngeal mucosa were 27.78% and 25.00%, respectively. The differences were not significant (P > 0.05). The abnormal expression rates of E-cadherin and β-catenin were 61.11% and 76.39% respectively. The expression of ERβ correlated negatively with the loss of E-cadherin, nuclear translocation of β-catenin and increased TNM stage. The differences were significant (P < 0.05).@*CONCLUSION@#The positive expressions of ERβ suggest a good prognosis in the differentiation, clinical stages and lymphatic metastasis of the laryngeal carcinoma. The underlying mechanism may be related with the abnormal expressions of E-cadherin and β-catenin.

An animal experimental study on access to mediastinum with flexible endoscope via suprasternal fossa / 中华消化内镜杂志

Objective To evaluate the feasibility and safety of mediastinum examination with flexible endoscope via suprasternal fossa.Methods A total of 20 healthy pigs were enrolled.Mediastinocosopy was performed via a tunnel to thoracix through a 1.5 cm incision on suprastemal fossa.Mediastinum was observed and complications were recorded.Results Mediastinocosopy was successfully achieved in all pigs.No severe bleeding or death occurred during the procedure.Five pigs got fever after the procedure with elevated white blood cell count.Four pigs had pneumothorax and three of them died in 1-6 days.Conclusion Mediastinocosopy with flexible endoscope through suprastemal fossa is feasible to diagnose mediastinal diseases,which can be important experimental evidence for the mini-invasive therapy of mediastimum diseases.

Establishment of a porcine model of biliary leakage with laparoscopy / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a animal model of biliary leakage in pigs with laparoscopy.</p><p><b>METHODS</b>Eight healthy Bama minipigs were subject to laparoscopic surgery under general anesthesia.The cystic duct was resected at 0.5-1.0 cm from the root and the stump was left open with the gallbladder removed. Blood routine and hepatic functions of the pigs were tested before and 24 h after the surgery, and endoscopic retrograde cholangiography (ERC) was performed 24 h after the surgery. At 48 h after the surgery, the pigs were sacrificed for observation of the stump of the cystic duct.</p><p><b>RESULTS</b>The gallbladder, cystic duct, cystic artery, and the anatomical relations between the gallbladder and liver and between the cystic duct and common bile duct were fully exposed under laparoscopy. White blood cells, neutrophils and direct bilirubin increased significantly after the operation (P<0.05). The cystic ducts were resected at 0.5-1 cm away from the roots of the cystic ducts in 7 pigs and at 2 cm in 1 pig.</p><p><b>CONCLUSION</b>Laparoscopy is safe and feasible for establishing the porcine model of biliary leakage.</p>

The prevalence and genotype of human parvovirus B19 in blood products / 中华微生物学和免疫学杂志

Objective To study the prevalence and genotype of human parvovirus B19 virus among blood products and plasma pools in China. Methods B19 DNA derived from 16 lots of factor Ⅷ concentrate produced by 4 manufactures and 10 lots of plasma pools were detected by nested PCR. Phylogenetic comparison of the partial B19 sequences obtained from positive samples were performed by direct sequencing. Results Twelve of sixteen lots of factor Ⅷ concentrate and all of ten lots of plasma pools were contaminated by B19 DNA. By comparing the partial B19 sequences,all the isolated viruses were genotype Ⅰ and their nucleotides were high conserved with homology of 98. 3%-100%. Conclusion B19 genotype Ⅰ DNA has been detected in high prevalence in factor Ⅷ concentrate and plasma pools. The genetic diversities were shown to be very low.