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Objective:To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) for adult severe tetanus by comparing the NLR in patients with severe and mild tetanus.Methods:A total of 65 adult tetanus patients from the Linyi Central Hospital from January 2009 to December 2020 were enrolled. The patients were divided into two groups including mild group and severe group according to the Ablett classification. The general conditions, laboratory data, and NLR of patients in two group were retrospectively compared using independent samples t test. Multivariate logistic regression analysis was used for the analysis of risk factors for severe tetanus. Spearman correlation method was used for the analysis of the correlation between risk factors and Ablett grades. Receiver operator characteristic (ROC) curve was used for the evaluation of the predictive value. Results:Among the 65 tetanus cases, 34 was in mild group and 31 in severe group. The latency period of patients in severe group was (7.00±3.19) d, which was shorter than that in mild group ((9.18±2.59) d), and the difference was statistically significant ( t=3.03, P=0.004). The NLR of patients in severe group was 4.251±1.936, which was higher than that of mild group (2.533±1.026) , and the difference was statistically significant ( t=4.41, P<0.001). Multivariate logistic regression analysis showed that NLR and latency period were independent risk factors for tetanus severity (odds ratio ( OR)=2.359, 95% confidence interval ( CI) 1.415 to 3.934, P=0.001 and OR=0.748, 95% CI 0.599 to 0.936, P=0.011, respectively). In tetanus patients, the NLR level was positively correlated with Ablett grade ( r=0.644, P<0.001). The ROC curve showed that NLR had good predictive value for adult severe tetanus at a cut-off value of 2.471 (area under the curve (AUC)=0.787), with the sensitivity and specificity of 87.1% and 61.8%, respectively. When combining NLR with latency period (cut-off value of 7.5 d), predictive efficiency was further improved (AUC=0.832) with the sensitivity of 87.1% and specificity of 67.6%( Z=3.43, P<0.001). Conclusions:NLR has a good predictive value for adult severe tetanus, and the predictive efficiency is further improved when combined with latency period.
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Objective:To investigate the clinical application value of nano-carbon tracer technology in lymph node dissection and postoperative pathological examination in laparoscopic mid-low rectal cancer resection.Methods:Fifty-two patients with mid-low rectal cancer were randomly divided into experimental group (n=27) and control group (n=25).Before surgery,the Nano-group were injected nano activated carbon suspension liquid under the mucosa.Both groups were accepted the same principles of open colorectal cancer radical surgery.The total number of lymph nodes,number of tiny lymph nodes,number of black dye and number of metastasis lymph node confirmed by pathology in the two groups were statistical analysised.Results:There were 905 pieces of lymph node seized in two groups toally,including (20.67 ± 5.751) medals in Nano-carbon group and (13.88 ±4.466) medals in control group.Lymph node number in nano carbon group was more than control group (P＜0.01).Nano-carbon group seized 113 tiny lymph nodes,significantly higher than 49 in the control group (P＜0.05).The metastasis rate of lymph node was no significant difference in the two groups (P＞0.05).Nano-carbon group seized lymph node metastasis was no significant difference in the rate of the control group (P＞0.05).Nano-carbon group seized 341 black dyed lymph nodes and 217 not black dye lymph nodes.And 67 cases of metastasis lymph nodes in Black dye lymph nodes,15 cases of metastasis lymph nodes in not the black dye lymph nodes.The metastasis rate of black dye lymph node was higher(P＜0.01).Conclusions:Nano-carbon tracer technique can guide the surgeon to accurately lymph nodes dissection during the operation,and can add to the number of lymph nodes in the postoperative surgical specimens,improve lymph nodes in patients with colorectal cancer radical seized quantity.Nano-carbon tracer technique can ensure the accuracy of the pathological staging,there was important clinical significance to lymph node dissection in Mid-low colorectal cancer,which provide an important basis for the development of postoperative adjuvant therapy programs.
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Objective To investigate the relationship of expression of cyclooxygenase-2(COX-2) and vascular endothelial growth factor(VEGF) with the growth pattern,malignant degree,metastasis and prognosis of gastrointestinal stromal tumor(GIST).Methods The expression of COX-2 and VEGF was examined with immunohistochemistry from paraffin-embedded tissue sections of 54 patients with GIST,and special attention was given to analyze the relationship between COX-2、VEGF expressions and clinicopathologic factors of the neoplasm.Results The expression of COX-2 and VEGF was significantly higher in malignant GIST than in benign and potentially malignant GIST(P