Background and purpose:Colorectal cancer (CRC) is a malignancy which is the third incidence and the fourth mortality in the worldwide. The main reason for the development of CRC is that the changes of genetic and epigenetic causes the tumor suppressor gene methylation silencing. This study aimed to investigate the plasma and stool GATA5 gene promoter methylation was detected in clinical diagnosis of CRC. Methods: To collect the paired plasma and stool specimens of 34 cases of healthy and 43 cases of patients with CRC. Methylation speciifc PCR (MSP) was respectively detected the GATA5 gene methylation levels of GATA5 gene in plasma and stool. And then separately analyzed their correlations with clinical and pathological parameters in gastric carcinoma. Results: The result of MSP showed that GATA5 gene promoter methylation rates in plasma and stool of CRC patients were 60.74%, 76.60%, respectively, were higher than those of healthy persons (6.47%, 32.35%). And the differences were statistically signiifcant (P=0.006 7, P=0.000 2, respectively). GATA5 gene methylation rates in plasma of CRC patients were closely related to clinical stage (P=0.000 5) and lymph node metastasis(P=0.020), while GATA5 gene methylation rates in stool of CRC patients had no signiifcant with clinical and pathological parameters. Conclusion:Detection of faecal GATA5 gene methylation level and supplemented plasma GATA5 gene methylation level can become a simple, non-invasive, sensitive and speciifc method for clinical diagnosis of CRC.

Objective:To investigate the diagnostic value of the promoter methylation of plasma RNF180 gene and its protein ex-pression for the detection of gastric cancer. Methods:Methylation-specific polymerase-chain reaction (MSP) and enzyme-linked immu-no-sorbent assay (ELISA) were performed to detect DNA methylation and protein expression of the RNF180 gene, respectively. The correlations of DNA methylation and protein expression of the RNF180 gene with the clinico-pathological parameters of gastric carcino-ma were then separately analyzed. Results:MSP showed that the methylation rates of the RNF180 gene were 62.75%and 21.88%in the plasma of patients with gastric carcinoma and healthy volunteers, respectively;this result indicated that the two groups significantly differed (P<0.01). The methylation of the RNF180 gene was associated with tumor size, clinical stage, tumor differentiation, lymph node metastasis, and distant metastasis (P<0.05). ELISA results showed that the protein expression of the RNF180 gene [(23.22 ± 1.36)μg/mL] was significantly lower (P<0.01) in the plasma of patients with gastric carcinoma than in the plasma of healthy volunteers [(34.25 ± 2.44)μg/mL]. However, the protein expression of the RNF180 gene was not associated with clinicopathological parameters (P>0.05). Conclusion:The RNF180 gene is expressed at a hypermethylation rate, and the corresponding protein expression level is de-creased in the plasma of individuals with gastric carcinoma. Therefore, RNF180 gene methylation in plasma could be applied to detect microinvasion for the clinical diagnosis of gastric cancer.

Objective:To assess the impact of preoperative short-course radiotherapy combined with neoadjuvant chemotherapy on elderly patients with locally advanced rectal cancer after a 2-year follow-up.Methods:In this retrospective cohort study, we included 446 consecutive cases of elderly patients diagnosed and treated for locally advanced rectal cancer(stage Ⅱ-Ⅲ with T3-T4 and/or positive regional lymph nodes)at the First People's Hospital of Shangqiu city from January 2012 to December 2019.The patients were divided into two groups based on the treatment method: an observation group(107 cases)and a control group(339 cases).The patients in the observation group underwent preoperative short-course radiotherapy combined with neoadjuvant chemotherapy.The regimen included short-term radiotherapy(25 Gy over 1 week in 5 fractions)followed by 4 courses of chemotherapy(CAPOX regimen).On the other hand, the control group received concurrent radiotherapy and chemotherapy.The regimen involved 50 Gy over 5 weeks in 25 fractions and concurrent capecitabine chemotherapy.Afterward, total rectal mesentery resection was performed, and postoperatively, 2 and 6 courses of CAPOX chemotherapy were continued.Follow-up was conducted until 31 December 2021, with the primary observation being the disease-free survival(DFS)of patients in both groups.Secondary observations included overall survival(OS)time, lesion progression-free survival(PFS)time, local recurrence rate, and the rate of acute toxicity events.Cox regression analyses were conducted to compare the factors influencing DFS.Results:Among the 446 patients, 303(67.9%)were male and 143(32.1%)were female.The patients in the observation group were found to be younger and had a higher proportion of Eastern Collaborative Oncology Group(ECOG)physical status score 0 compared to the control group(both P<0.05).Additionally, the two groups differed significantly in terms of MRI T stage, N stage, distance from the external anal verge, rectal mesorectal fascial infiltration, pathological stage, and chemotherapy-to-surgery time interval(all P<0.05).Throughout a mean follow-up period of(20.7±3.5)months, there were 76 deaths, 89 distant metastases, and 32 local recurrences.The results of Kaplan-Meier survival analysis revealed that the observation group had a higher disease-free survival(DFS)rate at 2 years of follow-up compared to the control group[73.8%(79/107) vs.68.1%(231/339), Log-rank χ2=2.676, P=0.041].Additionally, the median DFS time was longer in the observation group[19(12, 22)months]compared to the control group[16(11, 19)months]( Z=2.774, P=0.038).Furthermore, the observation group exhibited a significantly longer OS time[26(21, 33)months]compared to the control group[22(18, 14)months]( Z=2.879, P=0.032).However, the median PFS time was similar in both groups[20(14, 25)months vs.16(12, 21)months]( Z=1.545, P=0.123).The incidence of distant metastasis was 18.7%(20/107)in the observation group and 20.4%(69/339)in the control group(Log-rank χ2=0.341, P=0.708), indicating no significant difference.Similarly, there was no significant difference in the risk of local recurrence between the observation group[9.3%(10/107)]and the control group[6.5%(22/339)](Log-rank χ2=0.996, P=0.318).In terms of adverse reactions, there was no statistically significant difference in the incidence of grade≥3 acute toxic reactions between the two groups[19.6%(21/107) vs.12.1%(41/339), Log-rank χ2=1.661, P=0.148].A multifactorial Cox regression analysis revealed that age( HR=0.586, P=0.005), ECOG score( HR=0.721, P=0.028), MRI T-stage( HR=0.605, P=0.008), rectal mesenteric fascial infiltration( HR=1.649, P=0.012), and distance from the external anal verge( HR=0.638, P=0.041)were associated with DFS. Conclusions:The findings indicate that the combination of preoperative short-course radiotherapy and neoadjuvant chemotherapy in elderly patients with locally advanced rectal cancer demonstrates favorable short-term effectiveness and safety.This approach shows promise in improving outcomes for elderly patients with locally advanced rectal cancer.

Objective To investigate the pathological and magnetic resonance imaging(MRI)characteristics of orbital diffuse large B-cell lymphoma(DLBCL).Methods A total of 48 patients with orbital DLBCL were selected via a retrospective case-control study in the orbital DLBCL group,and 5 1 patients with DLBCL of primary central nervous system during the same period were included in primary DLBCL group.The clinical characteristics and MRI features of the orbital DLBCL group were analyzed,and the pathological characteristics and peripheral blood platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR),and lymphocyte-to-monocyte ratio(LMR)were com-pared between the two groups.Results The main clinical manifestations of orbital DLBCL patients in-cluded local orbital mass in 48 cases(100.00％),limited ocular motility in 38 cases(79.17％),ex-ophthalmos in 33 cases(68.75％),decreased visual acuity in 25 cases(52.08％),diplopia in 17 cases(35.42％),and epistaxis in 9 cases(18.75％).Orbital DLBCL predominantly occurred in the extraconal space(54.17％),with lesions mostly located above the orbit(52.08％).T1-weighted im-ages mainly showed intermediate signal intensity(60.42％),T2-weighted images mainly showed in-termediate(56.25％)and high signal intensity(29.17％),diffusion-weighted images mainly showed high signal intensity(58.33％),and apparent diffusion coefficient maps mainly showed low signal intensity(60.42％).There were no statistically significant differences in histopathological subtype,CD20 positive expression,CD79a positive expression,CD45RO positive expression,International Prognostic Index score,and pathological stage between the two groups(P＞0.05).The PLR in the orbital DLBCL group was higher,while NLR and LMR were lower than that in the primary DLBCL group(P＜0.05).Conclusion Orbital DLBCL exhibits specific clinical manifestations and MRI characteristics.MRI can serve as the primary diagnostic tool,and its combination with pathological immunohistochemical analysis and peripheral blood PLR,NLR,and LMR test results can improve the accuracy and timeliness of diagnosis.

Objective To investigate the effects of continuing nursing on quality of life in elderly with H type hypertensive caused cognitive impairment. Methods A total of 108 elderly with H type hypertension and cognitive impairment were randomized to control group and experimental group. The blood pressure, homocysteine, blood fat, blood coagulation indexes, and level of quality of life characteristics were assessed the baseline. The patients of control group underwent routine nursing and no intervention after discharge, while the patients of experimental group received continuing psychological and life care after discharge. We reexamined compared the above indicator after 12 months discharged. Results The blood pressure was (163. 7 ± 12. 9)/(96. 9 ± 10. 2) mmHg decreased to ( 134. 1 ± 7. 8 )/( 77. 5 ± 6. 0 ) mmHg, homocysteine decreasing from (18. 20 ± 8. 40)μmol/L to (11. 56 ± 4. 28)μmol/L, the total cholesterol declining from (5. 48 ± 0. 65)mmol/L to (4. 06 ± 0. 74) mmol/L, triacylglycerol from (2. 58 ± 0. 63) mmol/L to (1. 47 ± 0. 76) mmol/L, frbrinogen from (4. 83 ± 1. 46)g/L to (2. 78 ± 1. 46) g/L, prothrombin time from (13. 54 ± 1. 93) sec to (15. 10 ± 2. 38) sec with statistical significance (t=3. 267, 3. 487, 4. 483, 5. 031, 5. 327, 3. 467, 5. 082;P<0. 01) after treatment in experimental group. Compared with control group, there were statistical significance ( t=4. 986,3. 462, 3. 384, 3. 325, 4. 021;P <0. 01). The physiology, physiological function, physical pain, general health status, energy, social function, emotional function and mental health were (55. 92 ± 8. 40), (59. 48 ± 11. 65), (61. 44 ± 9. 75), (58. 03 ± 14. 72), (49. 83 ± 13. 46), (55. 58 ± 16. 18), (58. 44 ± 14. 33), (60. 46 ± 10. 96) score in the control group lower than (86. 56 ± 14. 28), (89. 26 ± 12. 74), (83. 44 ± 15. 75), (79. 21 ± 12. 66), (84. 20 ± 10. 48), (87. 55 ± 11. 71), (93. 19 ± 12. 38), (89. 32 ± 10. 57) in the experimental group (t =7. 893, 6. 934, 7. 351, 7. 214, 7. 359, 8. 254, 8. 657, 7. 536;P <0. 01). Conclusions The quality of life decreased in elderly with H type hypertensive and cognitive impairment. Comprehensive nursing for elderly with H type hypertensive patients and cognitive impairment can improve quality of life compared with patients without nursing.

Objective To investigate the pathological and magnetic resonance imaging(MRI)characteristics of orbital diffuse large B-cell lymphoma(DLBCL).Methods A total of 48 patients with orbital DLBCL were selected via a retrospective case-control study in the orbital DLBCL group,and 5 1 patients with DLBCL of primary central nervous system during the same period were included in primary DLBCL group.The clinical characteristics and MRI features of the orbital DLBCL group were analyzed,and the pathological characteristics and peripheral blood platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR),and lymphocyte-to-monocyte ratio(LMR)were com-pared between the two groups.Results The main clinical manifestations of orbital DLBCL patients in-cluded local orbital mass in 48 cases(100.00％),limited ocular motility in 38 cases(79.17％),ex-ophthalmos in 33 cases(68.75％),decreased visual acuity in 25 cases(52.08％),diplopia in 17 cases(35.42％),and epistaxis in 9 cases(18.75％).Orbital DLBCL predominantly occurred in the extraconal space(54.17％),with lesions mostly located above the orbit(52.08％).T1-weighted im-ages mainly showed intermediate signal intensity(60.42％),T2-weighted images mainly showed in-termediate(56.25％)and high signal intensity(29.17％),diffusion-weighted images mainly showed high signal intensity(58.33％),and apparent diffusion coefficient maps mainly showed low signal intensity(60.42％).There were no statistically significant differences in histopathological subtype,CD20 positive expression,CD79a positive expression,CD45RO positive expression,International Prognostic Index score,and pathological stage between the two groups(P＞0.05).The PLR in the orbital DLBCL group was higher,while NLR and LMR were lower than that in the primary DLBCL group(P＜0.05).Conclusion Orbital DLBCL exhibits specific clinical manifestations and MRI characteristics.MRI can serve as the primary diagnostic tool,and its combination with pathological immunohistochemical analysis and peripheral blood PLR,NLR,and LMR test results can improve the accuracy and timeliness of diagnosis.

Objective To summarize the experience of multi-disciplinary team(MDT)in the pediatric department of Qujing Maternal and Child Health Hospital,and to evaluate the effectiveness of MDT on neonatal brain injury.Methods The clinical data of children with brain injury and treated in the pediatrics department of Qujing Maternal and Child Health Hospital from November 2019 to April 2023 were collected.The children with brain injury and treated from October 2019 to June 2020 were regarded as the non-MDT group,and the children with brain injury and treated from July 2020 to April 2023 were regarded as the MDT group for comparative analysis.Chi-square test/t-test was used to compare and analyze the clinical data of the two groups.Results Among the 890 cases of pediatric brain injury,there were 519 males and 371 females.The median and quartiles of the age distribution for the two groups were as follows:MDT group 2.00(0.82,5.00)years and non-MDT group 1.00(1.00,4.00)years.Craniocerebral injury was the main type of brain injury in both groups,in addition,among children with craniocerebral injury and intracranial hemorrhage,the cure rate of MDT group was higher than that of non-MDT group,and the difference was statistically significant(P<0.05).Among the 405 children in MDT group,154(38.0%)underwent the surgery,while among the 485 children in non-MDT group,121(24.9%)underwent the surgery.The difference was statistically significant(P<0.05).23.2% of children in MDT group were in critical condition during the hospitalization,which was significantly lower than that in non-MDT group(30.5%),and the difference was statistically significant(P<0.05).The unhealed rate of MDT group(2.0%)was also significantly lower than that of non-MDT group(5.6%),the cure rate of MDT group(40.5%)was significantly higher than that of non-MDT group(34.4%),and there was a statistically significant difference(P<0.05).The expense of treatment,medicine and sanitary materials in MDT group were lower than those in non-MDT group,and the differences were statistically significant(P<0.05).The multivariate Logistic regression model analysis of the cure rate of children with brain injury showed that the MDT model could effectively improve the cure rate of children with brain injury(RR = 1.513,95% CI = 1.134-2.020).The results of multiple linear regression model analysis showed that there was no statistical difference in the effect of MDT on the actual hospitalization days of children(P>0.05).Conclusion Using MDT model to diagnose and treat children with brain injury is helpful to improve the cure rate,reduce the risk of children's disease aggravation,and achieve the significant therapeutic effects in children with brain injury.MDT model is worth popularizing and applying in children with brain injury.

Heilongjiang Province has unique geographical environment, which makes the difference in population morbidity. This paper summarizes the physiological and pathological characteristics of stroke in Longjiang area from the regional factors and dietary factors. The paper also summarizes the treatment thoughts of acupuncture and moxibustion doctors in Longjiang area, mainly including five aspects: Knowing all diseases but treating the essence one, combining theory and practice, combining Chinese and western medicine, combining acupuncture and Chinese medicine, preventing diseases through learning and observing tiny clues. This article aims to summarize the experience of Longjiang acupuncture scholars and enriches the medical connotation of Longjiang area.

Objective:To investigate the clinical, endoscopic and pathological features, and treatment and prognosis of gastric adenocarcinoma of fundic gland type of chief cell predominant type (GA-FG-CCP).Methods:Data of 40 GA-FG-CCP patients with 41 lesions diagnosed by histopathology at Ningbo Medical Center Lihuili Hospital and Shanghai East Hospital from January 2018 to May 2023 were collected. Their clinical and endoscopic features, pathological features, immunohistochemical results, endoscopic treatment, and prognosis were analyzed.Results:Among the 40 GA-FG-CCP patients, there were 15 males and 25 females, and the mean age was 60.03 years. Most of them had no obvious clinical symptoms or family history of tumor. Except one case, others had no helicobacter pylori infection. The endoscopic features of white light observation were: ① the main location was the upper part of the gastric body (63.41%, 26/41); ② faded or whitish mucosal surface (56.10%, 23/41); ③ dilated vessels with branch architecture (78.05%, 32/41); ④ no background mucosal atrophy (100.00%, 41/41). The features of magnifying endoscopy with narrow band imaging (ME-NBI) were: ① no obvious demarcation line (85.37%, 35/41); ② enlargement of the crypt opening (87.80%, 36/41); ③ widening of the intervening part (92.68%, 38/41); ④ lack of irregular microvascular pattern (95.12%, 39/41). All patients were confirmed gastric adenocarcinoma of the fundic gland by biopsy. The glands showed a low degree of dysplasia, similar to the differentiation of chief cell predominant pattern, also with scattered parietal cells, forming irregular and anastomosing cords. In the 40 patients, 20 did not receive endoscopic therapy. Twelve out of 21 lesions in 20 cases treated with endoscopic resection infiltrated into the submucosa (20-520 μm), 9 cases were intramucosal carcinoma. There was no lymphatic or venous infiltration, and horizontal and vertical margins were negative. Immunohistochemical staining results showed that the tumor was postive for pepsinogen-Ⅰ and MUC 6, with scattered postive for H +-K +-ATPase, but negative for MUC5AC, MUC2 and CD10, and the Ki-67 labeling index was low. No patients had recurrence or metastasis during mean follow-up of 15.85 months. Conclusion:GA-FG-CCP is rare and very well differentiated. Its clinical symptoms are not obvious, but there is endoscopic characteristics. The detection rate of GA-FG-CCP can be improved by white light and ME-NBI, and the diagnosis can be confirmed by pathology and immunohistochemical staining.

Objective:To explore the effect of stepwise nursing in postoperative rehabilitation of patients with spinal cord injury.Methods:From January 2020 to June 2021, convenience sampling was used to select 91 patients with spinal cord injury admitted to the Henan Third Provincial People's Hospital as the research object. The patients were divided into the observation group ( n=46) and the control group ( n=45) by random number table method. The control group received routine nursing, while the observation group received stepwise nursing on the basis of the control group. The postoperative functional independence and quality of life were compared between the two groups. Results:After six months of intervention, the scores of the Spinal Cord Independence Measure Ⅲ and the scores of each dimension of the Generic Quality of Life Inventory 74 in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Stepwise nursing can promote postoperative functional recovery and improve the quality of life of patients with spinal cord injury.