Objective: To study the influence of clinicopathologic factors on the recurrent pattern of colorectal cancer after radical treatment. Methods: There were 464 consecutive patients with colorectal cancer treated with radical surgery between January 1998 and December 2002 in our hospital. The clinicopathologic features of 90 patients with relapse of colorectal cancer after radical surgery were analyzed. According to the interval between radical surgery and recurrence, these 90 patients were divided into subgroups, the early recurrent group (within 30 months after surgery) and the late recurrent group (more than 30 months after surgery). Chi-square test was used for univariate analysis, and the Logistic regression model was performed for multivariate analysis. Result: There were 78 (86%) patients in the early recurrent group and 12 (14%) patients in the late recurrent group. The median time of recurrence was 17.4 months. The median recurrent time in stage I patients was 35.1 months, 13.6 months in stage II patients, and 12.9 months in stage III patients, respectively. Univariate analysis showed that the depth of penetration, the number of positive lymph nodes, and the gross appearance of tumor were predictors for early recurrence. Multivariate analysis revealed that the depth of penetration (T category) of the primary tumor significantly predicted for early recurrence (P= 0.049). Conclusion: A great proportion of recurrence in patients with colorectal cancer occurred within 30 months after radical treatment, but the late recurrence which occurs at more than 30 months after radical surgery should not be neglected. Patients with different patterns of recurrence had different intervals between radical surgery and recurrence. DM (distant metastasis) occurs earlier than LR (local recurrence). The depth of penetration of the primary tumor is an independent predictor for early recurrence of colorectal cancer patients after radical surgery.

Impaired clearance of apoptotic cells is important in the pathogenesis of autoimmune disease.C-reactive protein (CRP) is an acute phase protein that plays a major role in the regulation of the autoimmune and inflammatory response .CRP has a role in the clearance of bacteria and dying and altered cells through binding to phosphocholine and might also have more complex immunomodulatory functions . CRP function as opsonins for pathogens and dying and apoptotic cells through activation of the complement pathway and through binding to Fcγreceptors , and is associated with the clearance of apoptotic cells and nuclear antigen , thus becoming a protective molecule against pathogenic autoimmune responses in general . Measurement of serum CRP level is in widespread clinical use as a sensitive marker of inflammation and autoimmune disease , particularly in relation to the use of the CRP-based disease activity score in the evaluation of rheumatoid disease.

Objective To study the clinical discrepancy between patients with post infectious irritable bowel syndrome(PI-IBS) and non post infectious irritable bowel syndrome(NPI-IBS),and assess the value of serum intestinal fatty acid binding protein (I-FABP) for differential diagnosis.Methods A total of 117 patients with PI-IBS,201 patients with NPI-IBS and 31 healthy controls were prospectively recruited in General Liberation Army Hospital from 2010 to 2013.Plasma samples and clinical data were collected.Serum I-FABP level was measured by an enzyme-linked immunosorbent assay.Results The median age of patients with PI-IBS was 36 years.The median time to diagnosis in PI-IBS group was significantly longer than that in NPI-IBS group [(19.7 ± 10.3) months vs (11.4 ± 5.3) months,P ＜ 0.05].Similarly,the proportion of anxiety [58.1％ (68/117) vs 28.9％ (58/201),P ＜ 0.05] and the value of I-FABP[(42.6 ± 14.8) μg/L vs (17.3 ± 11.5) μg/L,P ＜ 0.05] in PI-IBS group were significant higher than NPI-IBS patients.The level of I-FABP of healthy controls [(10.6 ± 8.2) μg/L] was also significantly lower than that of PI-IBS patients (P ＜ 0.05),yet no difference from that of NPI-IBS group.The I-FABP value of subgroup PI-IBS patients with diarrhoea (IBS-D) was significant higher than that of NPI-IBS group [(54.8 ± 9.3) μg/L vs (12.3 ± 6.2) μg/L,P ＜ 0.05].However,other parameters including gender,age,GSRS score,and I-FABP value of subgroup constipation (IBS-C) and mix (IBS-M),were not different between PI-IBS group and NPI-IBS group (all P ＞ 0.05).Conclusion PI-IBS is an occult intestinal inflammation disease with mucosa injury.I-FABP might be a potential testing marker for the diagnosis of PI-IBS.

Objectives To investigate the risk factors of acute renal injury (acute kidney injury) in patients with acute left heart failure.Methods Clinical data of 188 patients with acute left heart failure who were admitted to our hospital were retrospectively analyzed.Logistic regression analysis was used to assess the risk factors for AKI.Results Among 188 patients with acute left heart failure,incidence of acute kidney injury was 33.51％.Univariate and Multivariable logistic regression analyses showed that the independent predictors of acute kidney injury were lower baseline eGFR (OR=4.294,P ＜ 0.001) and anemia (OR=3.573,P=0.006).Conclusions The incidence of acute left heart failure complicated with AKI was high.Basic state of renal function and anemia were the independent risk factors for AKI.

Objective To investigate the effects of erythropoietin (EPO) on complement 3a (C3a)-induced renal tubular epithelial to mesenchymal transition. Methods The HK-2 cells were divided into 6 groups namely control group,EPO group,TGF-β group,TGF-β+EPO group,C3a group and EPO+C3a group.The mRNA and protein expressions of α-SMA,E-cadherin and C3 were investigated by RT-PCR,Western blot and immunofluorescence respectively. Results Compared with control group and EPO group,the mRNA and protein expressions of α-SMA in HK-2 cells were up-regulated after the intervention of C3a or TGF-β (all P＜0.05).On the contrast,the mRNA and protein expressions of E-cadherin were down-regulated(P＜0.05),the mRNA and protein expressions of C3 were enhanced (all P＜0.05).However,all those above effects of C3a or TGF-β were inhibited after the intervention of EPO (all P＜0.05). Conclusion EPO is capable of suppressing the epithelial to mesenchymal transition induced by C3a.

AIM:To study the effect of epigallocatechin-3-gallate (EGCG) on the proliferation of human naso-pharyngeal carcinoma ( NPC) cells, and to explore its mechanism by targeting miR-34a.METHODS: Nasopharyngeal carcinoma CNE-2Z cells were treated with various concentrations of EGCG .The ability of cell proliferation was detected by CCK-8 assay, 5-ethynyl-2-deoxyuridine (EdU) incorporation assay and colony-forming assay.The cell cycle distributions were analyzed by flow cytometry .The protein levels of P53 and Notch1 were detected by Western blot .The expression of miR-34a and Notch1 mRNA was measured by real-time PCR.RESULTS:EGCG effectively inhibited the proliferation and colony formation of CNE-2Z cells in a dose-dependent manner , which was related to its induction of cell cycle arrest at G 0/G1 phase.The expression of P53 and miR-34a in CNE-2Z cells was significantly increased after treated with EGCG , while the expression of Notch1 at mRNA and protein levels was markedly suppressed .CONCLUSION:EGCG induces cell cycle arrest and suppresses cell proliferation by regulating the P 53/miR-34a/Notch1 pathway in NPC cells.

Objective : To investigate the epidemiological and clinical characteristics of cases with pertussis in Yiwu City, Zhejiang Province, so as to provide insights into pertussis diagnosis and control. Methods: A total of 186 patients with definitive diagnosis of pertussis in medical institutions in Yiwu City from November 1, 2020 to August 31, 2022 were recruited, and subjects' demographic, clinical symptoms and history of pertussis vaccination were collected using questionnaire surveys. The temporal, population, and spatial distribution and clinical symptoms of pertussis were analyzed using a descriptive epidemiological method, and the clinical characteristics of pertussis patients with different doses of pertussis vaccination were compared. Results: Pertussis was found to predominantly occur during the period between July and November (101 cases, 54.30%), and the three highest-incidence regions included Jiangdong Street, Beiyuan Street and Choujiang Street (87 cases, 46.77%). The 186 pertussis cases included 105 males (56.45%) and 81 females (43.55%), and included 144 cases with age of onset under 7 year (77.42%). Preschool and diaspora children were predominant among all pertussis cases, and the main clinical symptoms included spasmodic cough (97 cases, 52.15%), post-tussive vomiting (82 cases, 44.09%) and aggravated cough at night (77 cases, 41.40%). Routine blood tests measured 119 cases with abnormal white blood cell counts (63.98%), 137 cases with abnormal lymphocyte counts (73.66%), 39 cases with abnormal neutrophil counts (20.97%), 21 cases with abnormal platelet counts (11.29%) and 111 cases with abnormal hemoglobin concentrations (59.68%). There were 55 cases that were unvaccinated (29.57%), 23 cases that were not fully vaccinated (12.37%), and 108 cases that were fully vaccinated (58.06%). There were significant differences among pertussis cases with different doses of vaccination in terms of age, incidence of post-tussive vomiting, percentage of abnormal platelet counts and percentage of hemoglobin concentrations (all P<0.05). Conclusions The majority of pertussis cases are preschool and diaspora children in Yiwu City from November 1, 2020 to August 31, 2022, and the clinical symptoms mainly include spasmodic cough, post-tussive vomiting and aggravated cough at night, with atypical symptoms. The capability for differential diagnosis of pertussis is required to be improved in medical institutions.

Obj ective To explore effecy of conyinuous nursing conyinuous nursing in improv-ing pain and qualiyy of life in payienys wiyh rheumayoid aryhriyis.Methods 80 payienys wiyh rheumayoid aryhriyis were randomly divided inyo yhe observayion group and yhe conyrol group,yhe conyrol group was only received discharge guidance while yhe observayion group was given conyinuous nursing,disease syayus and living condiyion afyer discharge of ywo groups were compared.Results Medicayion compliance afyer 2 monyhs’discharge in yhe observayion group was higher yhan yhay in yhe conyrol group,morning syiffness yime was shoryer yhan yhay in yhe conyrol group,joiny yender-ness index was lower yhan yhay in yhe conyrol group,self-care abiliyy and sleep qualiyy was beyyer yhan yhay in yhe conyrol group,yhe anxieyy and depression was less yhan yhay in yhe conyrol group, yhe resulys above revealed yhay yhe difference was syayisyically significany (P<0 .05 ).Life qualiyy of physiological funcyion,physical pain and social funcyion in yhe observayion group was higher yhan yhay in yhe conyrol group,so yhe difference was syayisyically significany (P<0.05).Conclusion Conyinuous nursing can improve yhe syaye of disease of rheumayoid aryhriyis payienys afyer discharge, reduce pain and improve yhe life qualiyy.

Objective To explore effect of health education in patients with rheumatoid arthritis.Methods A total of 60 patients with rheumatoid arthritis were randomly divided into observation group and control group.The control group was only given medication instruction while the observation group strengthened health education program.Treatment condition,efficacy and life quality of two groups were compared.Results The health knowledge awareness in the ob-servation group was higher than that in the control group.The medication compliance,compliance of joint exercise and regular review of compliance were higher than that in the control group.Cura-tive effect was higher than that in the control group and pain scores were lower than that in the control group.The results above showed significant difference(P <0.05).Life quality in physical function,psychologicalfunction and social function in the observation group were higher than that in the control group,and the differences were statistical significant(P <0.05).Conclusion Health education can improve the compliance,efficacy and the life quality.

Obj ective To explore effecy of conyinuous nursing conyinuous nursing in improv-ing pain and qualiyy of life in payienys wiyh rheumayoid aryhriyis.Methods 80 payienys wiyh rheumayoid aryhriyis were randomly divided inyo yhe observayion group and yhe conyrol group,yhe conyrol group was only received discharge guidance while yhe observayion group was given conyinuous nursing,disease syayus and living condiyion afyer discharge of ywo groups were compared.Results Medicayion compliance afyer 2 monyhs’discharge in yhe observayion group was higher yhan yhay in yhe conyrol group,morning syiffness yime was shoryer yhan yhay in yhe conyrol group,joiny yender-ness index was lower yhan yhay in yhe conyrol group,self-care abiliyy and sleep qualiyy was beyyer yhan yhay in yhe conyrol group,yhe anxieyy and depression was less yhan yhay in yhe conyrol group, yhe resulys above revealed yhay yhe difference was syayisyically significany (P<0 .05 ).Life qualiyy of physiological funcyion,physical pain and social funcyion in yhe observayion group was higher yhan yhay in yhe conyrol group,so yhe difference was syayisyically significany (P<0.05).Conclusion Conyinuous nursing can improve yhe syaye of disease of rheumayoid aryhriyis payienys afyer discharge, reduce pain and improve yhe life qualiyy.