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Objective:To evaluate the value of lymph node regional sorting in radical colorectal cancer surgery.Methods:Between Jan 2021 and Mar 2022, A total of 307 colorectal cancer patients undergoing radical surgery at the Tianjin Medical University General Hospital were retrospectively included and assigned to either the lymph node regional sorting group (123) or no-sorting group (184) according to the lymph node examination methods.Results:There was a significant difference between the two groups in the number of total lymph nodes and negative lymph nodes (26.74±13.08 vs. 16.80±4.87, t=9.381, P<0.001; 25.65±13.25 vs. 16.04±4.87, t=8.979, P<0.001). The number of positive lymph nodes of lymph node regional sorting group increased compared with no-sorting group (1.09±2.28 vs. 0.76±1.34, t=1.589, P=0.113). A total of 52 cases in the lymph node regional sorting group showed metastasis, of which 10 showed lymph node skip metastases. There was no significant difference in tumor location and TNM stage between skip and non-skip lymph node metastasis patients. Conclusions:The lymph node regional sorting increase the number of examined lymph nodes. The method can determine the positive lymph node distribution and ensure the accuracy of staging.
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Objective:To observe and analyze the function of intestinal barrier in patients with pouchitis, and to explore the role of nucleotide oligomerization domain 2 (NOD2) in ileal pouchitis, so as to provide new ideas for the pathogenesis of pouchitis.Methods:From January 2011 to December 2016, the clinical pathological data of patients with ileal pouch-anal anastomosis who underwent pouch mucosa biopsy at the Endoscopy Center of General Hospital of Tianjin Medical University were retrospectively analyzed. According to the disease activity index of pouchitis, patients were divided into pouchitis group (20 cases) and non-pouchitis group (30 cases). In addition, UC patients who did not undergo surgery were selected as the control group (10 cases). The intestinal structure of patients of the pouchitis group and non-pouchitis group was observed under transmission electron microscope. The positive expression rates of occludin, alpha human defensin and NOD2 in the control group, non-pouchitis group and pouchitis group were detected and calculated by immunohistochemistry. Levene test, independent sample t test and Spearman correlation analysis were used for statistical analysis. Results:Under the transmission electron microscope, the tight junction epithelial structure and microvilli of intestinal mucosal of patients in the pouchitis group were severely injured. The results of immunohistochemistry showed that the positive expression rates of occludin, alpha human defensin and NOD2 in the intestinal mucosa of patients in the pouchitis group were all lower than those of the control group and non-pouchitis groups ((19.3±0.4)% vs. (84.0±0.3)% and (77.9±0.5)%; (60.0±1.3)% vs. (85.0±0.1)% and (77.3±0.4)%; (46.1±1.6)% vs. (72.0±0.7)% and (60.7±0.5)%), and the differences were statistically significant ( t=-8.451, -7.514, -3.943, -2.970, -5.115 and -2.982, all P<0.05). The correlation analysis showed that the expression level of NOD2 was positively correlated with occludin and alpha human defensin ( r=0.671 and 0.628, both P<0.01). Conclusions:Intestinal barrier function is impaired in patients with ileal pouchitis, and NOD2-related intestinal barrier injury may play an important role in the pathogenesis of ileal pouchitis.
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Objective To evaluate the psychological intervention ettectiveness ot socioenvironmental therapyfor heroin addicts accepting compulsory isolation.Methods Totally 100 male heroin addicts accepting compulsory isolation and Labour Camp Rehabilitation were selected and randomly assigned to socioenvironmental therapeutic group (ST group,50 cases) and control group (CT group,50 cases).A two-month socioenvironmental therapy was selectively proceeding in ST group by a same psychological team,while CT group still received conventional rehabilitation.During the 6-month follow-up,self-rating anxiety scale(SAS),self-rating depression scal (SDS) and self-made questionnaires were used every 3 months,to statistically estimate psychological status of subjects.Results Before treatment,no statistically significant difference between the two groups;after treatment,SDS score of CT group was 56.16 ± 9.12,and was lower than that in ST group(48.28-± 9.55) (P ＜ 0.01) ; SAS score of ST group was 46.28 ± 7.78,and was lower than that in CT group (50.72 ± 8.32) (P ＜ 0.01).In the 3-month follow-up evaluation,depression,anxiety scores in CT and ST group were significantly lower,the difference was statistically significant (P ＜ 0.01) ; 6 months after treatment,depression,anxiety score showed was significant difference between two groups(P＜ 0.01).Conclusion Group psychotherapy especially socioenvironmental therapy is quick and long-acting in improving the psychological status of heroin addicts in aspects of depression and anxiety levels,which is distinctly evidenced by the short-term and long-term curative results.