Objective To construct nomogram model for individualized prediction of esophageal stenosis risk after endoscopic submucosal dissection（ESD） for early esophageal cancer. Methods A total of 198 patients treated with ESD in the digestive surgery department of our hospital from January 2016 to June 2019 were selected as the research objects.According to whether esophageal stenosis occurred after operation, the patients were divided into stenosis group and nonstenosis group. The influencing factors of esophageal stenosis after ESD in patients with early esophageal cancer were analyzed. R4.1.1 software was used to construct nomogram model for predicting esophageal stenosis risk after ESD in patients with early esophageal cancer. The receiver operating characteristic（ROC） curve and calibration curve were drawn to evaluate the discrimination and consistency of the nomogram model in predicting esophageal stenosis risk after ESD in patients with early esophageal cancer. Results Among 198 patients with early esophageal cancer treated by ESD, 51 cases had esophageal stenosis, with an incidence of 25.76%. Univariate analysis results showed that there were statistically significant differences in age, operation time, lesion longitudinal diameter, muscle layer injury, lesion circumference and infiltration depth between the stenosis group and the non-stenosis group（P＜0.05）. Multivariate Logistic regression analysis results showed that lesion longitudinal diameter ≥5 cm, muscular layer injury, lesion circumference≥3/4 circles and M3/SM1infiltration depth were risk factors for esophageal stenosis after ESD for early esophageal cancer（P＜0.05）. The area under the curve（AUC） of the nomogram model for predicting esophageal stenosis risk after ESD in patients with early esophageal cancer was 0.838. Hosmer-Lemeshow goodness-of-fit test showed there was a good consistency between the predicted probability of the nomogram and the current value（P=0.596）. Conclusion The lesion longitudinal diameter ≥5 cm, muscular layer injury, lesion circumference≥3/4 circles and M3/SM1 infiltration depth are risk factors for esophageal stenosis after ESD in patients with early esophageal cancer. The nomogram model constructed in this study has a good predictive ability for the risk of esophageal stenosis after ESD in patients with early esophageal cancer.
目的 探讨甲状腺功能正常人群甲状腺激素水平与代谢相关脂肪性肝病(MAFLD)的相关性.方法 选取2019年1月至12月就诊于苏州市相城区太平街道社区卫生服务中心的120例健康体检者作为研究对象,根据是否患有MAFLD将其分为正常组(n=79)和MAFLD组(n=41).比较两组的一般资料;分析甲状腺激素水平与代谢相关指标的关系;用多因素Logistic回归分析探讨影响MAFLD发生的危险因素.结果 研究对象的平均年龄(46.38±9.69)岁,其中41例符合MAFLD诊断标准,患病率为34.17％.MAFLD组的促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)水平均高于正常组,差异有统计学意义(P<0.05).Pearson秩相关分析结果显示:TSH与腰围(WC)、体重指数(BMI)、空腹血糖(FPG)、总胆固醇(TC)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)呈正相关,与高密度脂蛋白胆固醇(HDL-C)呈负相关(P<0.05);FT3与WC、BMI、FPG、TG、丙氨酸氨基转移酶(ALT)、AST、GGT呈正相关,与HDL-C呈负相关(P<0.05);游离甲状腺素(FT4)与指标间无相关性(P>0.05).多因素Logistic回归分析显示,TSH、FT3水平是影响MAFLD发生的独立危险因素(P<0.05).结论 甲状腺功能正常人群中TSH、FT3水平是影响MAFLD发生的独立危险因素.
Objective To investigate the application effect of extracorporeal mechanical side-to-side anastomosis and end-to-side anastomosis in laparoscopic-assisted radical resection of right colon cancer.Methods A total of 100 patients who underwent laparoscopic-assisted radical resection of right colon cancer from April 2019 to April 2021 were selected as the research objects.Based on the order of admission,the patients were divided into control group(50 cases,end-to-side anastomosis)and study group(50 cases,side-to-side anastomosis).The application effects of the two groups were compared.Results The intraoperative blood loss in the study group was less than that in the control group,the first ventilation time after operation and the recovery time of intestinal function after operation were shorter than those in the control group(P<0.05).At 3 d after operation,the levels of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the two groups were higher than those before operation,but those in the study group were lower than the control group(P<0.05).At 3 d after operation,the levels of CD3+,CD4+ and CD4+/CD8+ in the two groups were lower than those before operation,and CD8+ was higher than that before operation,but those in the study group were better than the control group(P<0.05).The total incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion Compared with end-to-side anastomosis,side-to-side anastomosis is more helpful to promote the recovery of gastrointestinal function in patients undergoing laparoscopic-assisted radical resection of right colon cancer,and has higher safety,which is of positive significance for improving the prognosis of patients.
Objective To explore the effect of budesonide formoterol powder inhalation combined with tiotropium bromide and salbutamol in the treatment of elderly bronchial asthma(BA).Methods A total of 120 elderly patients with BA admitted from April 2019 to June 2021 were selected as the research objects.According to different treatment schemes,the patients were divided into control group and observation group,with 60 cases in each group.The control group was treated with tiotropium bromide and salbutamol,and the observation group was treated with budesonide formoterol powder inhalation on the basis of the treatment plan of the control group.The therapeutic effects of the two groups were compared.Results The dyspnea relief time,asthma relief time,cough relief time and lung rale disappearance time in the observation group were shorter than those in the control group(P<0.05).After 4 courses of treatment,the thickness of bronchial mucosa's reticular basement membrane(TRBM)and mucosal myofibroblast count in the observation group were lower than those in the control group(P<0.05).After 4 courses of treatment,the levels of mast cell carboxypeptidase(MC-CP)and sphingosine-1-phosphate(S1P)in the observation group were lower than those in the control group(P<0.05).After 4 courses of treatment,the frequency of asthma attack in the observation group was less than that in the control group,and the duration of asthma was shorter than that in the control group(P<0.05).Conclusion Budesonide formoterol powder inhalation combined with tiotropium bromide and salbutamol has a significant effect in the treatment of elderly patients with BA,which can regulate the levels of MC-CP and S1P,promote airway remodeling,improve clinical symptoms,reduce the frequency of asthma attacks,and shorten the duration of asthma,it is worth promoting in clinic.
Objective To explore the effect of Jinkui Shenqi pill combined with modified Taohong Siwu decoction in the treatment of elderly patients with heart failure of Qi deficiency and blood stasis type.Methods A total of 90 elderly patients with heart failure of Qi deficiency and blood stasis type admitted from August 2019 to January 2022 were selected as the research objects.According to the random number table method,the patients were divided into control group and observation group,with 45 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Jinkui Shenqi pill combined with modified Taohong Siwu decoction on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After treatment,the interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT)and the left ventricular mass index(LVMI)in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of superoxide dismutase(SOD)and nitric oxide(NO)in the observation group were higher than those in the control group,and the level of malondialdehyde(MDA)was lower than that in the control group(P<0.05).Conclusion Jinkui Shenqi pill combined with modified Taohong Siwu decoction has a satisfactory effect in the treatment of elderly patients with heart failure of Qi deficiency and blood stasis type.It can improve ventricular remodeling function and reduce oxidative stress injury.
