A nomogram combining prognostic nutritional index and platelet lymphocyte ratio predicts postoperative pulmonary infection following D2 radical gastrectomy for gastric cancer.

Introduction: Introduction: the prognostic nutritional index (PNI) and platelet-lymphocyte ratio (PLR) have been found to correlate with outcomes following radical gastrectomy for gastric cancer (GC). Objectives: to construct a nomogram combining PNI and PLR for individually forecasting the risk of postoperative pulmonary infection (POI) following D2 radical gastrectomy for GC. Methods: retrospectively, clinical data was gathered from 404 patients treated with D2 radical gastrectomy for GC. The study used multivariate logistic regression analysis to screen independent risk factors for POI after surgery. Subsequently, a nomogram was developed based on the above factors to forecast the POI probability accurately. Results: the multivariate logistic regression analysis identified age, PNI, PLR, CA199 level, ASA score, and ICU treatment as independent risk variables for POI following D2 radical gastrectomy (p < 0.001 or 0.05). The nomogram's area under the receiver operating characteristic curve (AUC) for predicting the risk of POI was 0.736 (95 % confidence interval (CI) = 0.678-0.794). The nomogram was internally validated using the bootstrap approach, involving repeated sampling 1000 times. The result yielded a concordance index (c-index) of 0.707 (95 % CI = 0.705-0.709). The calibration curves demonstrated an excellent concordance between the predicted values of the nomogram and the observed values. The nomogram's clinical value was shown to be high using decision analysis curves. Conclusions: a nomogram combining PNI and PLR is a dependable tool for forecasting the probability of POI following D2 radical gastrectomy for GC.

Introducción: Introducción: se ha observado que el índice nutricional pronóstico (INP) y el cociente plaquetas/linfocitos (PLR) se correlacionan con los resultados tras la gastrectomía radical por cáncer gástrico (CG). Objetivos: diseñar un nomograma que combine el INP y la RPL para predecir individualmente el riesgo de infección pulmonar postoperatoria (POI) tras una gastrectomía radical D2 por CG. Métodos: de forma retrospectiva, se recopilaron datos clínicos de 404 pacientes tratados con gastrectomía radical D2 por CG. El estudio utilizó un análisis de regresión logística multivariante para detectar factores de riesgo independientes de IOP tras la cirugía. Posteriormente, se desarrolló un nomograma basado en los factores mencionados para pronosticar con precisión la probabilidad de POI. Resultados: el análisis de regresión logística multivariante identificó la edad, el INP, el PLR, el nivel de CA199, la puntuación ASA y el tratamiento en la UCI como variables de riesgo independientes para el POI tras la gastrectomía radical D2 (p < 0,001 o 0,05). El área bajo la curva ROC (característica operativa del receptor) AUC del nomograma para predecir el riesgo de POI fue de 0,736 (intervalo de confianza [IC] del 95 % = 0,678-0,794). El nomograma se validó internamente mediante el método bootstrap, que consiste en repetir el muestreo 1000 veces. El resultado fue un índice de concordancia (índice c) de 0,707 (IC del 95 % = 0,705-0,709). Las curvas de calibración demostraron una excelente concordancia entre los valores predichos del nomograma y los valores observados. El valor clínico del nomograma se demostró elevado mediante curvas de análisis de decisión. Conclusiones: un nomograma que combina INP y PLR es una herramienta fiable para predecir la probabilidad de POI tras gastrectomía radical D2 por CG.

[Effects of cypermethrin exposure during lactation of female mice on testicular steroidogenesis in male baby mice].

OBJECTIVE: To discuss the influence on the testicular steroidogenesis synthesation during baby mice cut-milking period and adult period of male mice by the cypermethrin exposure during lactation of the female mice. METHODS: Fourteen dams of new-born mice were randomly divided into two groups, cypermethrin poisoning group and solution control group. Since the first day after baby delivery, the aternal mice in the cypermethrin poisoning group were given stomach cypermethrin poisoning, using the corn oil as the solution and the poison dose is 25mg! kg, until the 21st day after the delivery when the baby mice has cut-milking. While the control group is given the gavagy of the corn oil of the same volume. In each group, 15 male baby mice were killed at 21st day and 70th day after delivery, respectively. Taking blood from the eye-balls, and separate the testes. Use radioimmunoassay (LIlA) method to measure serum testosterone (T) and estrogen (E2) levels. Use RT-PCR method to measure StAR in the testes and the mRNA expression level of testosterone synthetic enzymes. Use Western blot to measure StAR in the testes and the protein expression level of testosterone synthetic enzymes. RESULTS: Cypermethrin exposure during lactation of the female mice significantly leads to the decrease of serum testosterone of the male baby mice (P < 0.01) and the decrease of the testosterone in the testes (P < 0.05), having no influence of the female hormones (P < 0.05). And the cypermethrin exposure during lactation makes the significant decrease of the expression levels of the mRNA and the protein, of P450scc in the male baby mice testes, compared with the control group. And the mRNA expression levels of StAR, 17beta-HSD, and P450 17alpha decrease somewhat (P < 0.05), compared with the control group, but the protein expression levels of the above almost suffer no influence. Cypermethrin exposure during lactation of the female mice has almost no influence on the serum testosterone level, testosterone level in the testes, the StAR in the testes, and the expression levels of mRNA and protein of the testosterone synthetic enzymes (P > 0.05). CONCLUSION: Cypermethrin exposure during lactation may influence testosterone biosynthesis in the testes of the 21 days male baby mice, mainly by down-modulating mRNA and protein expression levels of testicular P450scc.

Maternal cypermethrin exposure during lactation impairs testicular development and spermatogenesis in male mouse offspring.

Within the last decade, numerous epidemiological studies have demonstrated that endocrine disruptors are a possible cause for a decline in semen quality. Cypermethrin is a widely used pyrethroid insecticide, but little is known about its potentially adverse effects on male reproduction. In the present study, we investigated the effects of maternal cypermethrin exposure during lactation on testicular development and spermatogenesis in male offspring. Maternal mice were administered with cypermethrin (25 mg/kg) by gavage daily from postnatal day 0 (PND0) to PND21. Results showed that the weight of testes at PND21 was significantly decreased in pups whose mothers were exposed to cypermethrin during lactation. Maternal cypermethrin exposure during lactation markedly decreased the layers of spermatogenic cells, increased the inside diameter of seminiferous tubules, and disturbed the array of spermatogenic cells in testes of pups at PND21. In addition, maternal cypermethrin exposure during lactation markedly reduced mRNA and protein levels of testicular P450scc, a testosterone (T) synthetic enzyme. Correspondingly, the level of serum and testicular T at weaning was significantly decreased in pups whose mothers were exposed to cypermethrin during lactation. Although the expression of testicular T synthetic enzymes and serum and testicular T in adulthood had restored to control level, the decreased testicular weight and histological changes were irreversible. Importantly, the number of spermatozoa was significantly decreased in adult male offspring whose mothers were exposed to cypermethrin during lactation. In conclusion, maternal cypermethrin exposure during lactation permanently impairs testicular development and spermatogenesis in male offspring, whereas cypermethrin-induced endocrine disruption is reversible.