[Therapeutic effectiveness of modified endoscopic retrograde appendicitis therapy for acute appendicitis of different severities in children].

Objective: To investigate the effects of modified endoscopic retrograde appendicitis therapy (mERAT) on the treatment of children with different severities of acute appendicitis. Methods: This study was a case-control study. A total of 586 children with acute appendicitis, who were admitted to the Pediatric Department of Second Affiliated Hospital of Air Force Medical University between January 2019 and November 2023, were selected as the research subjects. According to the severity of the disease, the patients were divided into simple appendicitis group, suppurative appendicitis group and perforated appendicitis group. The baseline data, hospitalization treatment and costs, outcomes, and recurrence in each group were analyzed, and the difference in the effectiveness of mERAT between the groups were compared by Kruskal-Wallis H test and χ2 test. Results: Among 586 children, there were 338 males and 248 females. The age at onset was 7.0 (4.6, 9.4) years. There were 475 cases of simple appendicitis, 78 cases of suppurative appendicitis, and 33 cases of perforated appendicitis. There were no significant differences in age and gender among the three groups (F=0.59, χ2=3.31, both P>0.05). However, there were statistically significant differences in body temperature, white blood cell counts, neutrophil percentage, lymphocyte percentage, nausea or vomiting, right lower abdominal pain, umbilical pain, right lower abdominal tenderness, and right lower abdominal rebound pain (H=7.56, 161.52, 169.11, and 169.61, χ2=12.05, 13.82, 12.05, 7.74, 20.35, and 94.61, all P<0.05). Also, the treatment time, postoperative hospital stay, total hospital stay, and cost showed statistically significant differences (H=4.70, 33.66, 34.99, 30.37, all P<0.05). There was no significant difference in the initial treatment success rate (98.1% (466/475) vs. 98.7% (77/78) vs. 90.9% (30/33), P=0.057). During the 30 (23, 36) months of follow-up, the recurrence rate was 7.9% (35/433) in the simple appendicitis group, 20.8% (15/72) in the suppurative appendicitis group, and 30.0% (9/30) in the perforated appendicitis group, with a statistically significant difference (χ2=23.56, P<0.001). Among the children with recurrent appendicitis, 15 cases still chose mERAT, of them 11 cases (31.2%) had simple appendicitis, 2 cases (2/15) had suppurative appendicitis, and 2 cases (2/9) had perforated appendicitis.The latest time to recurrence in the 3 groups was 32, 35 and 10 months, respectively. Conclusion: Treatment with mERAT has a good effect in pediatric simple appendicitis, but has a higher recurrence rate despite a better initial treatment success rate in suppurative appendicitis and perforated appendicitis.

[Clinical application value of prognosis of nutrition index and apparent diffusion coefficient in patient with hepatocellular carcinoma underwent transarterial chemoembolization].

Objective: To explore clinical application value of prognostic nutrition index(PNI) and apparent diffusion coefficient(ADC) in treating hepatic arterial chemoembolization (TACE) of patients with hepatic cell carcinoma (HCC). Methods: A total of 77 patients with HHC of BCLC B were retrospectively analyzed in Dalian Medical University Affiliated Second Hospital who were diagnosed for the first time and received TACE treatment from October 2017 to December 2018, of whom 64 Males, 13 females, mean age was 54±13 years.At 1 month after surgery, TACE efficacy was evaluated according to revised solid tumor evaluation criteria (mRECIST), the enrolled patients were divided into TACE effective group (41 cases, 53.2%) and TACE ineffective group (36 cases, 46.8%) to compare ability of PNI and ability of ADC alone or in combination in evaluating efficacy of TACE and the relationship between these two groups. Results: Overall postoperative PNI of enrolled patients was decreased compared with preoperative PNI, 47.7±6.6 vs 48.3±5.9 (P<0.05), preoperative and postoperative PNI of TACE effective group were all higher than that of TACE ineffective group (49.9±6.0 vs 46.6±5.3, 50.6±5.4 vs 44.4±5.1,all P<0.05), there was no significant difference in PNI between the treatment groups (P>0.05). The value of ADC in postoperative tumor region increased compared with that in preoperative tumor region ((1.43±0.15) ×10(-3) vs (1.28±0.08) ×10(-3) mm(2)/s, P<0.05), the difference between postoperative tumor region ADC value and postoperative normal liver parenchyma had no statistical significance(P>0.05). Overall postoperative PNI and tumor region ADC value of enrolled patients had linear correlation (P<0.05).Threshold value of PNI and ADC value in preoperative prediction were 51.05 and 1.32×10(-3) mm(2)/s; postoperative evaluation threshold value were 50.11 and 1.41×10(-3) mm(2)/s.Postoperative combination of PNI and ADC had the highest value in evaluating TACE efficacy. Conclusions: TACE postoperative PNI and tumor region ADC are related. PNI and tumor region ADC could be used in predicting and evaluating TACE efficacy in HCC patients, combination of these two could further increase the efficiency.

[Predictive value of diffusion-weighted magnetic resonance imaging in patients with esophageal carcinoma treated with radiotherapy: an animal trial].

Objective: To explore the value of diffusion-weighted magnetic resonance imaging (MR-DWI) technique in predicting the efficacy of radiotherapy in patients with esophageal cancer, using experimental animal models. Methods: BALB/c nude mice were subcutaneously injected with Eca-109 cell lines and then tumor formed. The experimental group (16 cases) received a single dose of 15 Gy (6 MV X-rays) delivered by a medical linear accelerator, while the control group (24 cases) did not receive any treatment. The two groups were scanned every other day, started one day before the radiotherapy. The scanning sequences included T1-weight imaging, T2-weight imaging, and DWI. The observation time was 1 month. According to the changes of the tumor volume and apparent diffusion coefficient (ADC) value of the two groups, 7 key time points were selected to observe the difference of cell density and tissue necrosis ratio between the two groups (6 cases in each group). Results: From day 7 after radiotherapy, the experimental group had statistically smaller volume of transplanted tumors than the control group, namely (1.729±0.906) cm(3) vs (2.671±0.915) cm(3)(P<0.05). From day 3 after radiotherapy, the experimental group had statistically higher ADC values [(1.017±0.255)×10(-6) vs (0.833±0.142)×10(-6) mm(2)/s, P<0.05], lower cell density of transplanted tumor (25.56±1.40 vs 33.48±4.18%, P<0.05), and less proportion of tissue necrosis [(32.19±1.21) % vs (29.16±2.16)%, P<0.05], respectively. The ADC value was negatively correlated with cell density (r=-0.703, P<0.001) and positively correlated with tissue necrosis ratio (r=0.658, P=0.003). Conclusions: Single dose of large fraction radiotherapy could inhibit the growth of xenograft. ADC values may change at the early stage prior to morphological changes of tumor. The change of cell density and necrosis ratio of transplanted tumor are in line with the change of ADC value. MR-DWI has the value of early prediction of esophageal cancer radiotherapy efficacy.

[Impact of primary tumor site on the prognosis in different stage colorectal cancer patients after radical resection].

Objective: To analyze the effect to the prognosis of tumor site on the patients of colorectal cancer after curative resection with different stage. Methods: Clinicopathological and follow-up data of 2 097 colorectal carcinoma cases undergoing resection at Fourth Hospital of Hebei Medical University from January 2008 to March 2015 were retrospectively analyzed. There were 421 patients in left-sided colorectal cancer (LCC) group (including carcinoma in cecum, ascending colon , hepatic flexure, and transvers colon) , 386 in right-sided colorectal cancer (RCC) group (including carcinoma in splenic flexure, descending colon and sigmoid colon) and 1 290 in rectal cancer (RECC) group. Clinicopathologic features in patients with different tumor location were compared. 5-year overall survival rate were compared among the 3 groups. Patients were stratified by different stage to analyze the effect of tumor location on the prognosis. χ(2)test and Kruskal-Wallis rank-sum test were used to compare the clinicopathological features among the 3 groups, Kaplan-Meier curve and Log-rank test were used to analyze prognosis, respectively. Results: No significant differences were identified between the three groups in age, family history, N stage and intestinal obstruction. Significant difference were found in gender among LCC, RCC and RECC group (male were 62.5% vs. 54.9% vs.56.3%, χ(2)=6.040, P=0.049) . Compared with LCC group and RCC group, RECC group had more well and moderately differentiated adenocarcinoma patients (89.7% vs. 86.0% vs. 82.4%, χ(2)=10.712 and 17.385, P=0.013 and 0.001) , more stage Ⅰ patients (17.1% vs. 6.9% vs. 6.5%, χ(2)=37.459 and 37.208, P=0.000 and 0.000) , and less likely to be stage T4 (44.7% vs. 76.7% vs.78.5%, χ(2)=128.015 and 133.704, P=0.000 and 0.000), metastasis (2.6% vs. 5.7% vs. 3.6%, χ(2)=1 417.167 and 1 424.217, P=0.000 and 0.000) and intestinal obstruction (11.3% vs. 21.1% vs. 24.4%, χ(2)=25.846 and 41.141, P=0.000 and 0.000). Five-year survival rate reduced in turn in the patients with RECC, LCC and RCC(70.9%, 59.8%, 58.9%, χ(2)=11.577, P=0.009). In the subgroup of stage Ⅲ, patients with different tumor location had different overall survival (χ(2)=9.878, P=0.007). Compared to right-sided colon cancer patients, rectal ones had significantly better overall survival (χ(2)=9.271, P=0.002); but in the subgroup of stage Ⅰ, Ⅱ and stage Ⅳ, patients with different tumor location had similar overall survival (P were 0.124, 0.888, 0.263, respectively). Conclusions: Colorectal cancer patients with tumor location had different clinicopathologic features. Patients with rectal cancer had better five-year survival rate than those with left located and right located colon cancer. Tumor location had different effects on the prognosis according to the different TNM stage-subgroups.

Drug use and its associated factors among money boys in Hunan Province, China.

OBJECTIVES: To describe drug use, types of drugs and related factors among money boys in Hunan Province, China. STUDY DESIGN: A cross-sectional study was conducted between July 2012 and January 2013. METHODS: Based on respondent-driven sampling, researchers located seven 'seeds' via a gay-dating website: http://www.ixxqy.org. After three waves of recruitment, 234 money boys were enrolled. They were asked to complete a 23-item questionnaire regarding demographic characteristics, drug use, a history of human immunodeficiency virus infection and family environment. Descriptive statistics and logistic regression analysis were conducted using Statistical Package for the Social Sciences Version 20.0. RESULTS: In total, 205 valid questionnaires were collected. Based on the data collected, 80 (39.0%) money boys had used drugs within the last 3 months. Rush popper (36.6%) and methamphetamine (12.7%) were used most commonly, and other drugs used were ecstasy (7.8%), ketamine (5.9%), marijuana (2.4%), morphine (1.5%), heroin (1.0%) and cocaine (0.5%). Factors included in the logistic regression were length of service (odds ratio [OR] 0.395, 95% confidence interval [CI] 0.175-0.896), being an only child (OR 2.272, 95% CI 1.108-4.659), relationship between parents (OR 0.428, 95% CI 0.213-0.858) and social network (OR 2.387, 95% CI 1.144-4.970). A shorter length of service and a good relationship between parents were protective factors against drug use, while being an only child and having a wide social network were risk factors. CONCLUSION: Drug use is common among money boys. This study found that length of service, being an only child, relationship between parents and social network are associated with drug use.

Differential proteome analysis of porcine skeletal muscles between Meishan and Large White.

Western and indigenous Chinese pig breeds show obvious differences in muscle growth and meat quality; however, the underlying molecular mechanism remains unclear. In this study, proteome analysis of LM between purebred Meishan and Large White pigs was performed by 2-dimensional gel electrophoresis and mass spectrometry. A total of 25 protein spots were differentially expressed in the 2 breeds. The 14 identified proteins could be divided into 4 groups: energy metabolism, defense and stress, myofibrillar filaments, and other unclassified proteins. Quantitative real-time PCR was used to analyze the partly differentially expressed proteins in mRNA level, which revealed a positive correlation between the content of the proteins and their mRNA levels. We also analyzed the mRNA levels of myosin heavy chain isoforms using quantitative real-time PCR. The results indicated that IIa and IIx fibers were elevated in Meishan pigs, whereas the IIb fiber was more highly expressed in Large White pigs. To the best of our knowledge, this was the first proteomics-based investigation of total skeletal muscle protein in different pig breeds, and these results may provide valuable information for understanding the molecular mechanism responsible for breed-specific differences in growth performance and meat quality.

Pathologic analysis of the brain from Streptococcus suis type 2 experimentally infected pigs.

Streptococcus suis type 2 (S. suis 2) is known as a major porcine pathogen worldwide and causes meningitis, septicemia, endocarditis, arthritis, and septic shock in pigs. Suilysin, a secreted protein of S. suis 2, is considered to be an important S. suis 2 virulence-associated factor. In this paper, the cerebellar lesions following experimental infection of pigs with S. suis 2 were studied. An immunohistochemical technique was applied to compare the distribution of bacteria and secreted suilysin protein in brain. The infected pigs developed histologic lesions of meningoencephalitis. Immunohistochemistry identified bacteria within the cytoplasm of neutrophils and macrophages localized in meningeal lesions. The secreted suilysin protein showed a similar localization within the cytoplasm of inflammatory cells, indicating that suilysin had high expression in vivo and may contribute to the pathogenesis of streptococcal meningoencephalitis.

Analysis of 4628 cases in the genetic counselling clinic of PUMC Hospital.

An analysis of 4628 cases in the genetic counseling clinic of PUMC Hospital is reported. Althogether 966 cases (20.87%) were diagnosed as having genetic diseases, among whom were 436 cases (45.13%) with chromosome aberrations, 161 (16.67%) with inherited metabolic diseases, 111 (11.49%) with constitutional bone diseases, 103 (10.66%) with various kinds of genetic neuromuscular diseases, 109 (11.28%) with different dysmorphic syndromes, and 46 (4.76%) with different kinds of genetic dermatoses and oculopathies. 973 cases (21.02%) were suspected to suffer from some form of genetic disease, but this could not be proved due to a lack of specific diagnostic methods. 2689 cases (58.10%) were found to be unaffected by inherited diseases. Some of the experiences gained and the key role of genetic counselling in family planning are briefly discussed.