Perioperative risk factors for survival outcomes in elective colorectal cancer surgery: a retrospective cohort study.

BACKGROUND: Surgical resection remains the best option for long-term survival in colorectal cancer (CRC); however, surgery can lead to tumor cell release into the circulation. Previous studies have also shown that surgery can affect cancer cell growth. The role of perioperative factors influencing long-term survival in patients presenting for CRC surgery remains to be investigated. METHODS: This retrospective single-center cohort study was conducted to collect the clinical data of patients who underwent elective laparoscopic resection for CRC from January 2014 to December 2015, namely clinical manifestations, pathological results, and perioperative characteristics. Survival was estimated using the Kaplan-Meier log-rank test. Univariable and multivariable Cox regression models were used to compare hazard ratios (HR) for death. RESULTS: A total of 234 patients were eligible for analysis. In the multivariable Cox model, tumor-node-metastasis (TNM) stage (stage IV: HR 30.63, 95% confidence interval (CI): 3.85-243.65; P = 0.001), lymphovascular invasion (yes: HR 2.07, 95% CI 1.09-3.92; P = 0.027), inhalational anesthesia with isoflurane (HR 1.96, 95% CI 1.19-3.21; P = 0.008), and Klintrup-Makinen (KM) inflammatory cell infiltration grade (low-grade inflammation: HR 2.03, 95% CI 1.20-3.43; P = 0.008) were independent risk factors affecting 5-year overall survival after laparoscopic resection for CRC. CONCLUSIONS: TNM stage, lymphovascular invasion, isoflurane, and KM grade were independent risk factors affecting CRC prognosis. Sevoflurane and high-grade inflammation may be associated with improved survival in CRC patients undergoing resection.

Efficacy and safety of interferon α-2b spray for herpangina in children: A randomized, controlled trial.

OBJECTIVES: The treatment of acute herpangina is inconsistent. We aim to evaluate the effectiveness and safety of interferon α-2b spray versus Ribavirin for this disease. METHODS: A randomized, controlled trial was conducted in eight hospitals in China between 2016 and 2018. 668 patients (1-7 years old) were randomized into an experimental group (treated with Interferon α-2b spray) or control group (received Ribavirin Aerosol). Body temperature returning to normal within 72 h and remaining so for 24 h was the primary outcome; release of oral herpes and adverse events were the secondary outcomes. RESULTS: (1) The average age of onset was 2.5 years old. (2) After 72 h treatment, body temperature of 98.5% patients in experimental group and 94.3% in control group returned to normal and remained so for 24 h (P = 0.004). The differences were greater at 48 h treatment (95.2% vs. 85.9%, P < 0.001) and at 24 h (77.5% vs. 66.5%, P = 0.001). (3) The rate of improved oral herpes in the experimental group was higher than that in control group (46.7% vs.37.1%, P = 0.011). No adverse reaction occurred. CONCLUSIONS: Local application of recombinant interferon α-2b spray showed better efficacy for acute herpangina in children. It was safe for use.

[Therapeutic Effect of PE+CRRT Combined with Chemotherapy on Children with Severe EBV-HLH and Non-EBV-HLH].

OBJECTIVE: To investigate the difference in the therapeutic effect of plasma exchange and continuous renal replacement therapy (PE+CRRT) combined with chemotherapy in the treatment of children with severe Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) and non-EBV-HLH. METHODS: The clinical data of 21 cases of all children with severe HLH treated by PE+CRRT combined with chemotherapy from January 2017 to January 2020 were collected and retrospectively analyzed. According to the presence of EBV infection, the children were divided into EBV+ group and EBV- group. The differences of the observation indexes between the children in the two groups and the improvement of the observation indexes of each group before and after treatment were compared. RESULTS: Among the 21 children, 14 were divided into the EBV+ group and 7 were divided into the EBV- group. There was no difference in age, sex and the number of organ damage between the children in the two groups (P>0.05). Duration of PE+CRRT was longer in the EBV+ group as compared with the EBV- group (P<0.05). Before treatment, the ANC in the EBV+ group was lower than that in the EBV- group (P<0.05), and there was no significant difference in the other observation indexes between the two groups (P>0.05). After treatment, Hb, Fib, APTT, SF, ALT, AST, LDH, Alb, CHE, TBil and TBA of the children in the EBV+ group were significantly improved as compared with those before treatment (P<0.05), but ANC, PLT, TG showed not improve (P>0.05); Fib, APTT, SF, LDH, Alb, and CHE in the EBV- group were significantly as improved compared with those before treatment (P<0.05), while the ANC, PLT, Hb, TG, ALT, AST, TBil, and TBA were not improved (P>0.05). After treatment, the differences of Fib and SF in the children between the EBV+ group and the EBV- group were statistically significant (P<0.05), and there was no significant difference in the other observation indexes of the children between the two groups (P>0.05). Compared with the children before treatment, EBV-DNA in the EBV+ group were decreased significantly in 2-4 weeks after treatment (P<0.05). After PE+CRRT combined with chemotherapy, the overall survival rate of the children with severe HLH was 66.7%, and there was no significant difference in overall survival rate between EBV+ group and EBV- group (P>0.05). CONCLUSION: PE+CRRT combined with chemotherapy can reduce serum ferritin quickly, then improve organ function, and increase the overall survival rate of severe HLH, and it is a good effect on children with severe EBV-HLH and non-EBV-HLH.

[BAX Deletion Accelerates Progression of BCR-ABL-Induced B-ALL in Mice].

OBJECTIVE: To explore whether BAX plays a role in the development of Philadelphia chromosome-positive leukemia and related mechanisms. METHODS: Target-gene knockout mice were used as bone marrow cell donors. Retrovirus over-expressing BCR-ABL were packaged. BCR-ABL-induced B-ALL mouse model was established through donor's B cells transfected by the retrovirus and the B cells over-expressing BCR-ABL were given to the receptor mice by tail vein injection. Western blot was used to detect the protein express and flow cytometry was used to analyze the B cell subpopulations in BAX-/- and WT mouse bone marrows. Kaplan-Meier analysis was used to estimate the survival of diseased mice. RESULTS: BAX deletion caused faster development of BCR-ABL-induced leukemia in vitro and in vivo. BCR-ABL increased BCL-2 expression and enhanced BCL-2/BAX heterodimer formation. CONCLUSION: The BAX deletion can accelerate the disease progression of BCR-ABL induced B-ALL.

[BAX Gene Deletion Reduces the Sensitivity of BCR-ABL-Induced B-ALL Cells of Mice to Imatinib].

OBJECTIVE: To investigate the effect of BAX gene deletion on the sensitivity of BCR-ABL-induced B-ALL cells of mice to imatinib and the related mechanism. METHODS: The target gene-knock out (BAX-/-) mice were used as bone marrow cell donors; the wild type bone marrow cells(B6BM) and BAX-/- bone marrow cells(B6BM-BAX-/-) of mice were transfected by using reverse transcription virus, then the BCR-ABL transfected B6BM cells and B6BM-BAX-/- cells were treated with imatinib at different concentration (0,0.5, 1.0 and 2.0 µmol/L) for 48 hours. The number of viable cells was detected by trypan blue, the flow cytometry was used to detect the cell apoptosis, the Western blot was used to detect the changes of BAX, Caspase expression. RESULTS: In BCR-ABL transfected bone marrow cells treated with imatinib, the numbers of viable cells of BAX deletion group was significantly higher than that of wild type groups with statristcal difference(P<0.05), and effect- and dose-dependency(r=-0.9533 for BAX deletion group, and r=-0.9812 for wild type group). The flow cytometry showed that the cell apoptosis in BAX deletion group signifincantly decreased, compared with wild type group(P<0.05). The Western blot showed that the expression of apoptotic protein Caspase 3 in BAX deletion group was significantly higher than that in wild type group(P<0.05). CONCLUSION: BAX deletion can reduce the sensitivity of BCR-ABL-induced B-ALL cells to imatinib.