This clinical study combined alanyl-glutamine and omega-3 polyunsaturated fatty acids (ω-3 PUFAs) to investigate the effects of parenteral nutrition on postoperative inflammation and nutritional status in patients with gastroduodenal perforation to provide a basis and support for the use of clinical immunonutrients. Patients with gastroduodenal perforations who underwent surgery between January 2018 and December 2023 were included. From the first to the seventh postoperative day, Group A (GA) received conventional postoperative nutrition with fat emulsion (20%), amino acids (17), and glucose (11%) injection; Group B (GB), building on GA’s regimen, was additionally treated with 10 g/day of ω-3 PUFAs; and Group C (GC), expanding on GB’s regimen, was additionally treated with 10 g/day of alanyl-glutamine. A total of 168 patients were included in the study, with 71 in GA, 30 in GB, and 67 in GC. Total protein and albumin (Alb) levels increased in all 3 groups, with GC showing a more significant increase compared to GB and GA (TP: 7.73 ± 5.00 vs 4.35 ± 5.85 vs 3.92 ± 5.07, P < .05; Alb: 4.07 ± 4.52 vs 1.79 ± 4.00 vs 2.11 ± 4.10, P < .05); C-reactive protein levels decreased in all 3 groups, with the most pronounced decrease in GC (93.71 ± 80.97 vs 72.04 ± 80.48 vs 55.79 ± 83.68, P < .05); the length of hospitalization and among the 3 groups was statistically significant (10.7 ± 2.27 vs 13.39 ± 4.66 vs 12.52 ± 3.46, P < .05), and GB was shorter than GA; the incidence of postoperative complications was significantly lower in GC than in other groups ( P < .05). Parenteral nutrition supplemented with alanyl-glutamine and ω-3 PUFAs can increase postoperative total protein and Alb levels, thereby improving patient nutritional status, reducing the production of the inflammatory marker C-reactive protein, mitigating the inflammatory response, and decreasing the incidence of postoperative complications, thus improving patient prognosis.

Objective: To develop a novel, straightforward diagnostic scale for predicting large vessel occlusion (LVO) and anterior circulation LVO (ALVO) in the emergency setting, evaluating its validity against existing scales. Methods: We prospectively enrolled patients with suspected stroke presenting consecutively at the National Comprehensive Stroke Centre's emergency department between February 20, 2022, and November 11, 2022. Emergency physicians assessed each patient using the modified Cincinnati Prehospital Stroke Severity Scale (mCPSSS) and the National Institutes of Health Stroke Scale (NIHSS). The study analyzed the mCPSSS and other prevalent stroke scales to evaluate their efficacy in detecting LVO and ALVO, employing receiver operating characteristic curve (ROC) analysis and area under the curve (AUC) statistics to assess the scales' sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy. Results: A total of 383 patients with suspected stroke were included in this study. The performance in identifying LVO in the emergency setting was greatest for mCPSSS >= 2 with a sensitivity of 0.802 and specificity of 0.770, PPV of 0.644, NPV of 0.882, and accuracy of 0.781. mCPSSS >= 2 was 0.766 sensitive, 0.733 specific, PPV of 0.564, NPV of 0.886, and accuracy of 0.749 in predicting ALVO. The mCPSSS identified LVO and ALVO with an optimal cut-off value of 2, exhibiting AUC superior to those of other widely used stroke scales, with AUC values of 0.824 for LVO and 0.790 for ALVO. Conclusion: The mCPSSS could serve as an effective and straightforward scale for identifying LVOs in emergency settings. Clinical Trial Registration information: https://www.chictr.org.cn/ (ChiCTR2200056776).

Purpose:To investigate the combined effects of oral nutritional supplement (ONS) and intestinal microecology on postoperative nutrition status, inflammatory response and intestinal flora regulation colorectal cancer (CRC) patients. Methods:This prospective single-center randomized controlled trial (RCT) was conducted at Chongqing Yongchuan Hospital between December 2023 and December 2024. CRC patients were randomly assigned to one of two groups: a control group receiving ONS (55.8 g per dose, three times daily) or a test group receiving ONS (55.8 g per dose, three times daily) combined with bifidobacteria (1.5 g per dose, three times daily). Results:A total of 62 patients who undergoing radical colorectal cancer resection were enrolled. Participants were equally randomized into control and test groups (n = 31 each). At baseline, no significant differences in demographic characteristics, nutritional status, or inflammatory markers were observed between groups (p > 0.05). Prealbumin (PA; 174.0 ± 38.0 g/L vs. 149.7 ± 42.9 g/L, t = -2.358, p = 0.022), albumin (ALB; 36.6 ± 3.3 g/L vs. 33.1 ± 4.0 g/L, t = -3.745, p < 0.000), total protein (TP; 65.8 ± 5.1 g/L vs. 62.5 ± 6.3 g/L, t = -2.266, p = 0.027), and the changes in ΔT3-T2 in PA (32.9 ± 36.1 g/L vs. 13.3 ± 34.9 g/L, t = -2.180, p = 0.033), ALB (4.0 ± 4.5 g/L vs. 1.0 ± 3.7 g/L, t = -2.862, p = 0.006), and TP (7.5 ± 5.9 g/L vs. 4.0 ± 5.9 g/L, t = -2.333, p = 0.023) were significantly greater in the test group than in the control group. The reduction in C-reactive protein (CRP) from T2 to T3 (42.1 (27.1, 62.9) mg/L vs. 26.8 (10.7, 46.4) mg/L, Z = -2.752, p = 0.006) was significantly greater in the test group. Fecal DNA fingerprint analysis revealed that, compared with the control group, the test group presented significantly greater intestinal flora species richness and abundance. The time to first defecation was significantly shorter in the test group (4.5 ± 1.8 vs. 5.9 ± 1.7 days, t = 3.132, p = 0.003). Conclusion:Perioperative ONS combined with intestinal microbiota interventions improves postoperative nutritional status, modulates inflammatory dynamics, and accelerates intestinal function recovery. However, these interventions show limited impact on hospitalization duration and complication rates.

Severe preeclampsia is a condition that poses a threat to pregnant women and fetuses, which requires prompt treatment and intervention. The ferroapoptosis suppressor protein 1(FSP1)-ubiquinone10 (CoQ10)-nicotinamide adenine dinucleotide phosphate(NADPH) pathway, a recently identified pathway that inhibits ferroptosis, is parallel to the cystine/glutathione (GSH) /GPX4 pathway. However, its expression in pregnant women with severe preeclampsia has not yet been investigated. A total of 198 pregnant women were enrolled in the baseline characterization study, and we measure the levels of chemicals, proteins, and mRNAs associated with the FSP1/CoQ10/NADPH pathway in the placenta, umbilical arterial blood, and maternal blood of pregnant women with severe preeclampsia and normal pregnant women. The results indicate that severe preeclampsia has more serious adverse pregnancy outcomes, and ferroptosis does occur in its placenta. In addition, FSP1 and CoQ10 showed a downward trend in the placenta of pregnant women with severe preeclampsia, and the utilization rate of NADPH was also reduced. This study also found that the expression levels of FSP1 and CoQ10 were downregulated in both maternal blood and umbilical artery blood. Based on observations. results of this study, we suggest that FSP1 and CoQ10 can be used in the future as new biomarkers for monitoring the progression of severe preeclampsia, and that they may become new targets for the treatment of severe preeclampsia.

BACKGROUND:Patients suffering from chronic health conditions such as pulmonary diseases, cancer, cardiovascular problems, and diabetes mellitus (DM) are facing psychological disturbance while struggling to handle their physical illnesses. Among all chronic health conditions, DM Type II is one of the main reasons for depression across the population. OBJECTIVES:The study aimed to investigate the prevalence of depression among the diabetic population and to determine the relationship between depression severity and diabetic duration. METHODS:We designed a questionnaire-based study to identify the prevalence of depression in the diabetic population visited tertiary care hospital in Kohat, Khyber Pakhtunkhwa, Pakistan. Patients aged above 15 were included, and their health condition was evaluated according to the Patient Health Questionnaire 9 (PHQ-9) score. We investigated 1573 diabetic individuals, including 831 males and 742 females, for depression symptoms. Data was analyzed by the Chi-square test to obtain the association between diabetes and depression. The statistical significance between variables was determined by calculating the p-value. RESULTS:Among the patients who suffered from DM Type II, 32.8% of patients showed minimal depression, and 7.9% were found severely depressed. As diabetic duration prolongs, depression severity also rises, and among patients who have been suffering from DM type II for more than 13 years, most patients were suffering from moderately severe and severe depression. Moreover, depression severity was high in the patients aged over 60 years. CONCLUSION:The overall results showed that more than half of the total diabetic population was facing mild to severe depression. Based on our results, we suggest including a psychological and mental health investigation during the evaluation of diabetes in the patients. The study might help healthcare workers assess the psychological complications of diabetic patients.

OBJECTIVE:To investigate the clinical significance of fecal Syndecan-2 (SDC2) gene methylation combined with blood tumor abnormal protein (TAP) detection for the diagnosis of colorectal cancer (CRC) and its precancerous lesions. METHODS:A retrospective study was conducted to collect patients diagnosed with CRC or colorectal adenoma (Ade) from March 2020 to March 2023, and healthy people (Nor) without any gastrointestinal diseases during the same period as the control group. All participants underwent the fecal SDC2 gene methylation test, blood TAP test and fecal occult blood test (FOBT). The differences in the positivity rates of each index were compared, receiver operator characteristic curves were plotted and the area under the curve (AUC) was calculated to evaluate the diagnostic effects of different testing methods on CRC and its precancerous lesions. RESULTS:A total of 146 individuals were included in the study, including 69 CRC patients, 47 patients with Ade and 30 healthy individuals. The results showed that, SDC2, TAP and the combined assay had high comprehensive diagnostic efficacy for the diagnosis of CRC, but there was no significant difference between the three methods in terms of AUC, sensitivity, and specificity. However, for Ade, the combined detection was statistically significant, with a high AUC (0.905), high sensitivity (95.7%), and high specificity (86.7%). CONCLUSION:Fecal SDC2 gene methylation combined with blood TAP detection is an effective noninvasive screening and diagnostic method to enhance the early detection and treatment of CRC precancerous lesions, such as Ade, thereby reducing the incidence and mortality of CRC.

Background: This study aimed to investigate the expression of RSPO3 and (3-catenin in preeclampsia and the relationship between RSPO3 and (3-catenin levels and maternal-fetal outcomes. Material/Methods: We enrolled 60 pregnant women with preeclampsia and 60 pregnant women without preeclampsia. We collected peripheral blood from the patients upon admission; placenta and cord blood were collected after delivery. The expression of RSPO3 and (3-catenin in maternal blood, cord blood, and placenta was measured. We used the Spearman method to examine the correlations between clinical characteristics and RSPO3. Logistic regression modeling was used to identify the independent risk factors for preeclampsia. Results: RSPO3 and (3-catenin levels were decreased in the peripheral blood, cord blood, and placentas of women with preeclampsia, with significant differences (P<0.05). The preeclampsia group had more adverse pregnancy outcomes. RSPO3 level of the preeclampsia group was negatively correlated with systolic blood pressure (r=0.4654, P<0.001) and diastolic blood pressure (r=-0.4617, P<0.001) in cord blood, and systolic blood pressure (r=-0.5373, P<0.05) and diastolic blood pressure (r=-0.4898, P<0.05) in maternal blood. Conclusions: RSPO3 and (3-catenin were decreased in preeclampsia, RSPO3 was negatively correlated with blood pressure, and RSPO3 could be a risk factor for the development of preeclampsia.

PurposeIdentifying the etiology of acute ischemic stroke (AIS) before endovascular treatment (EVT) is important but challenging. In CT perfusion imaging processed by perfusion software, we observed a phenomenon called patchy profile sign (PPS), that is, the hypoperfusion morphology in RAPID software is a discontinuous sheet pattern. This phenomenon is predominantly observed in patients diagnosed with intracranial atherosclerotic stenosis (ICAS). The study intends to assess whether the PPS can be used to differentiate ICAS from intracranial embolism.MethodPatients with AIS due to M1 segment occlusion of the MCA who underwent mechanical thrombectomy were retrospectively enrolled. The receiver operating characteristic (ROC) curve analysis was performed to assess the value of PPS in predicting ICAS. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the PPS for prediction of ICAS were calculated.ResultsA total of 51 patients were included in the study. The PPS was observed in 10 of 19 (52.6%) patients with ICAS, and in 2 of 32 (6.3%) patients with intracranial embolism (p < 0.001). Interobserver agreement for identifying PPS was excellent (κ = 0.944). The sensitivity, specificity, PPV, NPV, and accuracy of the PPS for predicting ICAS were 52.6, 93.8, 83.3, 76.9, and 78.4%, respectively.ConclusionThe PPS on RAPID software is an imaging marker with high specificity for ICAS. Larger sample sizes are imperative to validate the findings.

ObjectiveFor liquid biopsy of cancer, the extraction of circulating cell-free DNA (cfDNA) from plasma is required. We evaluated the efficacy of use of magnetic submicron particles coated with abundant small zwitterions (MSP-ZEWBs) for extracting short fragments of cfDNA.MethodsWe developed and optimized an MSP-ZEWB-based cfDNA extraction method using ampholytic ion-exchange materials and compared its results with those using a control kit. We measured the cfDNA concentration by quantitative polymerase-chain-reaction and using the Qubit method and analyzed cfDNA fragmentation patterns using a bioanalyzer.ResultsThe fragment size of cfDNA isolated from glycine hydrochloric acid at a pH of 2.2 exhibited a better alignment with the DNA marker. The highest DNA intensity was observed at the final concentration of 0.8% polyethylene glycol 8000. The intensity of cfDNA decreased significantly when isolated from plasma with DNA marker using MSP-ZEWBs with an adsorption buffer containing guanidine hydrochloride or isothiocyanoguanidine. All fragments were successfully extracted using MSP-ZEWBs from both plasma and phosphate-buffered saline. Notably, the intensity of short cfDNA fragments isolated using MSP-ZEWBs remained consistent for recovery of long DNA fragments. indicating a potential selective of small fragments.ConclusionThe extraction of plasma cfDNA with MSP-ZEWBs requires no protein denaturation, shows resistance to cells remaining in plasma, and demonstrates higher overall efficiency and better reproducibility than other extraction methods. Use of MSP-ZEWBs may greatly enhance liquid biopsy of cancers through the analysis of plasma cfDNA in clinical practice.

BACKGROUND This study aimed to investigate the expression of RSPO3 and ß-catenin in preeclampsia and the relationship between RSPO3 and b-catenin levels and maternal-fetal outcomes. MATERIAL AND METHODS We enrolled 60 pregnant women with preeclampsia and 60 pregnant women without preeclampsia. We collected peripheral blood from the patients upon admission; placenta and cord blood were collected after delivery. The expression of RSPO3 and ß-catenin in maternal blood, cord blood, and placenta was measured. We used the Spearman method to examine the correlations between clinical characteristics and RSPO3. Logistic regression modeling was used to identify the independent risk factors for preeclampsia. RESULTS RSPO3 and ß-catenin levels were decreased in the peripheral blood, cord blood, and placentas of women with preeclampsia, with significant differences (P<0.05). The preeclampsia group had more adverse pregnancy outcomes. RSPO3 level of the preeclampsia group was negatively correlated with systolic blood pressure (r=-0.4654, P<0.001) and diastolic blood pressure (r=-0.4617, P<0.001) in cord blood, and systolic blood pressure (r=-0.5373, P<0.05) and diastolic blood pressure (r=-0.4898, P<0.05) in maternal blood. CONCLUSIONS RSPO3 and ß-catenin were decreased in preeclampsia, RSPO3 was negatively correlated with blood pressure, and RSPO3 could be a risk factor for the development of preeclampsia.

目的 探讨冻融胚胎移植术后即刻离床活动对术后排尿及妊娠结局的影响.方法 回顾性分析2018年1月至2020年7月在该院进行冻融胚胎移植的2058个周期患者的临床资料,根据患者移植术后是否即刻离床活动分为A组(移植术后即刻离床活动,1202例)和B组(移植术后平卧30 min后离床活动,856例).比较2组患者一般资料、移植术后尿潴留及尿不尽发生率、胚胎着床率、临床妊娠率、异位妊娠率、继续妊娠率等.结果 2组患者年龄、不孕年限、体重指数、移植日内膜厚度、胚胎着床率、临床妊娠率、异位妊娠率、继续妊娠率比较,差异均无统计学意义(P>0.05);A组患者移植术后尿潴留、尿不尽发生率均明显低于B组,差异均有统计学意义(P<0.05).结论 冻融胚胎移植术后即刻离床活动可降低术后尿潴留、尿不尽发生率,且不影响患者妊娠结局.

Objective To analyze the correlation between Alberta stroke program early CT score（ASPECTS） based on RAPID software and core infarction volume in patients with anterior circulation acute ischemic stroke with large vessel occlusion（AIS-LVO） over time window. Methods Ninety-eight patients with anterior circulation AIS-LVO over time window admitted to Yongchuan Hospital Affiliated to Chongqing Medical University from January 2019 to December 2021were selected and further divided into patients with definite onset time（51 cases） and patients with unclear onset time（47cases） according to the onset time. Clinical and imaging data of these patients were collected. ASPECTS was calculated by RAPID software. Spearman correlation coefficient was used to analyze the correlation between ASPECTS and core infarction volume, and receiver operating characteristic（ROC） curve was used to analyze the predictive value of ASPECTS for core infarction volume ≤70 ml. Results There was a negative correlation between ASPECTS and core infarction volume in patients with anterior circulation AIS-LVO over time window and patients with definite onset time among them（r s ＜0, P＜0.05）, but no correlation with patients with unclear onset time（P＞0.05）. ROC curve results showed that ASPECTS had predictive value for core infarction volume ≤70 ml in patients with anterior circulation AIS-LVO over time window and patients with definite onset time among them（P＜0.05）, and cut-off values were seven points. Conclusion The ASPECTS based on RAPID software of patient with anterior circulation AIS-LVO over time window are correlated with their core infarct volume, which can help to determine the further treatment of patients.

Background and objective:Preoperative transcatheter rectal arterial chemoembolization (TRACE) can enhance the pathological response rate in some patients with locally advanced rectal cancer (LARC). However, how to accurately identify patients who can benefit from this neoadjuvant modality therapy remains to be further studied. Deficient mismatch repair (dMMR) protein plays a crucial role in maintaining genome stability. A proportion of patients with rectal cancer are caused by the loss of mismatch repair (MMR) protein. Given the role of MMR in guiding the efficacy in patients with colorectal carcinoma (CRC), this study is designed to evaluate the effect of dMMR status on the response to neoadjuvant therapy through a retrospective analysis.Methods:We launched a retrospective study. First, we selected patients with LARC from the database, and these patients had received preoperative TRACE combined with concurrent chemoradiotherapy. Then, the tumor tissue biopsied by colonoscopy before intervention was taken for immunohistochemistry. According to the expression of MLH-1, MSH-2, MSH-6 and PMS-2, these patients were divided into dMMR protein group and proficient MMR (pMMR) protein group. All patients underwent pathological examination at the end of neoadjuvant therapy, either surgically excised tissue or colonoscopically biopsied tissue. The end point was the pathologic complete response (pCR) after TRACE combined with concurrent chemoradiotherapy.Results:From January 2013 to January 2021, a total of 82 patients with LARC received preoperative TRACE combined with concurrent chemoradiotherapy, and the treatment was well tolerated. Among 82 patients, there were 42 patients in the pMMR group and 40 patients in the dMMR group. 69 patients returned to the hospital for radical resection. In 8 patients, the colonoscopy showed good tumor regression grade after 4 weeks of interventional therapy and refused surgery. The remaining five patients were neither surgically treated nor reexamined by colonoscopy. 77 patients were eventually enrolled in the study. Individually, the pCR rates of these two groups (10%, 4/40 vs. 43%, 16/37) showed significant difference (P < 0.05). Biomarker analysis indicated that patients with dMMR protein had a better propensity for pCR.Conclusion:In patients with LARC, preoperative TRACE combined with concurrent chemoradiotherapy showed good pCR rates, especially in patients with dMMR. Patients with MMR protein defects have a better propensity for pCR.

Previous Chinese research revealed that diarsenic trioxide (As2O3) inhibits acute promyelocytic leukemia (PML) cell proliferation and initiates apoptosis through degradation of the PML-retinoic acid receptor protein. This study was to analyse whether As2O3 also had an effect on hepatocellular carcinoma (HCC) cells. As2O3 effects on various HCC cell lines and primary HCC cells were investigated in time and dose series, including measurements of cell growth, PML mRNA and protein expression, xenografted tumor formation, and the self-renewal Oct4 and hepatocyte marker expressions in mouse model xenografts or cells treated with PML siRNA. The results were analyzed by immunocytochemistry, quantitative reverse transcription PCR and western blotting as well as indocyanine green and Periodic Acid Schiff staining. As2O3 inhibited HCC cell and HCC cell-derived xenograft tumor formation in a time-dependent manner and reduced PML protein expression in HCC cells, but had limited effects on PML mRNA levels in cell nuclei. The HCC cell line HuH7 treated with As2O3 showed a decreased expression of alpha-fetoprotein and increased expression and transcription of mature hepatocyte markers, indicating differentiation of HCC cells into hepatocytes. Cytokeratin 18 protein and mRNA levels as well as tyrosine aminotransferase and apolipoprotein B mRNA transcriptions were enhanced by As2O3 as were the numbers of indocyanine green and Periodic Acid Schiff stained cells. In addition, As2O3 downregulated the expression of Oct4. In conclusion, since As2O3 inhibited HCC cell proliferation and HCC cell-derived xenograft tumor formation it is suggested that an appropriate concentration of As2O3 might be a promising therapy to treat HCC.

目的 利用血清铁蛋白预测妊娠期糖尿病(GDM)的发病风险,为孕期妇女合理补铁和预防妊娠期糖尿病的发生提供参考.方法 选取2017-2021年在重庆医科大学附属永川医院规范产检并分娩的孕妇630例,根据是否患有妊娠期糖尿病分为妊娠期糖尿病组(病例组)129例和未患妊娠期糖尿病组(对照组)501例.收集年龄、身高、体重等信息.在妊娠14～27+6周检测血清铁蛋白浓度;在妊娠24～28周规范进行75 g 口服糖耐量试验(OGTT),按国家标准诊断妊娠期糖尿病.用单因素分析法筛选妊娠期糖尿病发病的影响因素,将有统计学意义的因素进一步进行多因素logistic回归分析;将有统计学意义的单因素作受试者工作特征曲线下面积(ROC-AUC)拟合,预测妊娠期糖尿病发病风险.结果 共观察孕妇630例,血清铁蛋白中位数为26.66 μg/L,诊断妊娠期糖尿病129例,发病率为20.48％.单因素分析血清铁蛋白、年龄、孕次、产次、孕前BMI和学历6个因素,病例组与对照组有统计学意义的有:血清铁蛋白分别为 49.24(15.95～155.93)μg/L和 22.00(8.00～71.85)μg/L(Z=-14.379,P＜0.001),年龄分别为(30.83±4.80)岁和(29.05±4.44)岁(t=-4.00,P＜0.001),孕次分别为(2.92±1.59)次和(2.47±1.48)次(t=-3.03,P＜0.005),孕前BMI分别为(22.79±3.35)kg/m2和(21.90±3.35)kg/m2(t=-2.70,P＜0.01).多因素分析结果显示,血清铁蛋白和年龄是妊娠期糖尿病发生的风险因素,OR(95％CI)分别为1.042(1.033～1.052)(P＜0.001)和1.081(1.027～1.134)(P=0.002).血清铁蛋白预测妊娠期糖尿病的AUC(95％CI)为0.790(0.75～0.83);发生妊娠期糖尿病的阈值为 30.28 μg/L,其敏感性为 78.29％(101/129),特异性为64.87％(325/501),阳性预测值为 36.46％(101/277),阴性预测值为92.07％(325/353),超过该阈值发生妊娠期糖尿病的风险为6.66倍(Kappa=0.303,P＜0.001),调整年龄风险因素后为1.45倍,仍显示妊娠期糖尿病发生的风险显著增加.结论 血清铁蛋白可作为预测妊娠期糖尿病的独立风险因素,预测阈值30.28 μg/L,可为重庆地区孕期妇女预防妊娠期糖尿病和监测血清铁蛋白及缺铁性贫血补铁提供参考.

目的 探讨手术间隔期对经导管直肠动脉化疗栓塞联合放化疗的局部晚期直肠癌患者预后的影响.方法 收集2013年1月至2021年1月在陆军特色医学中心普通外科接受直肠动脉化疗栓塞联合同步放化疗的77例局部晚期直肠癌患者,根据直肠动脉化疗栓塞术与直肠癌根治术的手术间隔期将其分为长间隔组(n=38)和短间隔组(n=39).比较2组患者的病理反应、肿瘤消退分级、局部复发及远处转移情况等指标.结果 短间隔组患者病理完全缓解率[43.6％(17/39)]显著高于长间隔组[18.4％(7/38)],差异有统计学意义(P<0.05);但2组患者在肿瘤消退分级、局部复发及远处转移方面比较,差异均无统计学意义(P>0.05).结论 局部晚期直肠癌患者应在直肠动脉化疗栓塞结束后按期尽早行直肠癌根治术,可提高患者预后.

Objective: The aim of this study is to investigate the predictive value of relative surface area of hematoma on poor prognosis of spontaneous intracerebral hemorrhage (sICH). Materials and Methods: We retrospectively analyzed 102 patients with sICH who met the inclusion criteria, attending to Yongchuan Hospital of Chongqing Medical University from January 2019 to September 2020. Cranial CT within 6 h of onset was completed and repeated in 24 h. The volume and surface area of the hematoma are measured by software, and the relative surface area is calculated from the above data. The primary outcome was 90-day modified Rankin Scale (mRS) score, which was classified as good prognosis (<= 2 points) and poor prognosis (>2 points) according to the results. Univariate analysis and binary logistic regression analysis were used to calculate the effect of each variable on poor prognosis. Results: The study is comprised of 52 patients with favorable functional prognosis and 50 patients with unfavorable one. The findings showed that admission National Institutes of Health Stroke Scale(NIHSS), hematoma volume, relative surface area, hematoma expansion(HE) and serum calcium concentration were independent influencing factors for poor prognosis(P=0.004,0.007,0.023,0.001,0.035, respectively). ROC curve analysis revealed that the area under the curve of the relative surface area of the hematoma predicted poor prognosis was 0.894(95% CI 0.830-0.985, P <0.001), which was better than the rest of the variables. Conclusions: The relative surface area of hematoma in sICH is an independent risk factor for poor prognosis with a high predictive value, and large relative surface area suggests poor prognosis.

目的 了解临床护士对心电图理论知识的掌握和心电图识图水平,为心电图教学方向及重难点划分提供依据,积极探索提升临床护士心电图识图水平方法.方法 2021年2月14日至3月10日随机抽取重庆市各级医院的400名临床护士进行调查,采用自制调查问卷,内容包含心电图基础知识、图片识别能力测试及影响心电图学习因素等.结果 400名临床护士的心电图基础理论得分[6(4,8)分]和识图答题得分[40(25,55)分]均较低,对不同医院等级、不同学历、临床带教护士与否、心内专科护士与否分类比较,差异均有统计学意义(P<0.05).心内科护士对致命性心律失常心电图识别能力最高,与ICU、其他科室护士比较,差异均有统计学意义(P<0.001).结论 临床护士对心电图基础知识的掌握与识图水平整体不高,应积极采取相应的措施提升临床护士心电图知识水平.

SIGNIFICANCE We used an Akeso device to record the visual behavior of children with myopia in two learning modes. We found that online class mode may increase near-viewing time and reduce outdoor time compared with the traditional school mode and may be responsible for accelerating myopia progression. PURPOSE We aimed to explore the effects of visual behavior in different learning modes on myopia progression among children 9 to 11 years old. METHODS Forty-nine children were included and requested to use a wearable device to objectively record visual behavior in real time from November 2019 to November 2020; participants took online classes from mid-February to early May 2020 during this period. Data (including glasses-wearing time, outdoor time, and near-viewing time) were collected during two 14-day periods, which included the online class learning mode (March 2 to 15, 2020) and the traditional school mode (May 20 to June 2, 2020). Spherical equivalent refraction and axial length were obtained at baseline, at 6-month intervals, and 1 year later. RESULTS Outdoor time during online class mode (median, 9.5 minutes; interquartile range, 0.75 to 48 minutes) was significantly lower than during the school mode (median, 29 minutes; interquartile range, 11.50 to 50 minutes; P < .001). The mean ± standard deviation of near-viewing time was significantly different between online class mode (396.58 ± 114.41 minutes) and school mode (376.52 ± 93.99 minutes; P = .007, F = 19.56). In comparison with the baseline examination (−2.33 ± 0.81 D), mean spherical equivalent refraction in oculus dexter corresponding to the 6-month examination was decreased (−2.94 ± 0.83 D, P = .001), indicating a significant increase in myopia during online class mode. CONCLUSIONS This study provides evidence of the association of learning mode and myopia progression. Accelerated progression of myopia in online class mode may be related to increased near-viewing time and decreased time spent in outdoor activities.

Post-stroke depression (PSD) is the most common mood disorder caused by stroke. Stroke might bring about increased intestinal permeability accompanied by gut microbiota changes. According to the "gut-brain" axis hypothesis, increased intestinal permeability may contribute to PSD. Therefore, we investigated the association between increased intestinal permeability and the occurrence of PSD. Intestinal fatty acid binding protein (iFABP) is responsible for intestinal fatty acid absorption and transport and is often considered a biomarker of gut hyperpermeability, also known as leaky gut. We enrolled 48 healthy controls (HCs), 48 stroke patients without depression, and 48 PSD patients in this study. Plasma iFABP was measured in the three groups. CRP, LBP, and sCD14 were quantified for bacterial infection assessment. In addition, clinical laboratory indicators of lipid metabolism were assessed. The PSD patients exhibited higher iFABP levels compared with HCs and non-depressed stroke patients. Using OPLS discriminant analysis, four proteins (ApoA1, HDL-C, iFABP, and Lp(a)) were identified as potential biomarkers for distinguishing PSD patients from non-depression stroke patients. Our study discovered that elevated plasma iFABP levels in PSD patients correlated with the degree of depression, along with disturbed lipid metabolism. These findings also suggested the need to consider the role of a leaky gut in depression after stroke.