Objective To investigate the comparison of clinical effects between two models of alimentary reconstruction after total gastrectomy in the elderly patients with gastric cancer.Methods 70 patients receiving alimentary tract reconstructions of Orr-type Roux-en-Y reconstruction (Orrtype,40 cases) and modified Brawn Ⅰ (30 cases) from January 2007 to December 2012 were retrospectively analyzed.The operative time,amount of bleeding,early postoperative complications and mortality,food intake,nutritional status and alimentary tract function were compared at 6 months after surgery.Results There were no significant differences between the two methods in the operative time [(198.8±14.0)min vs 233.5±30.7)min,t=-l.697,P＞0.05)],amount of bleeding [(420 ± 43) ml vs (340 ± 25) ml t =-1.956,P ＞ 0.05],and early postoperative complications [(17.5％ vs 16.7％),x2 =0.008,P＞0.05].However,times of liquid diet intake and semi liquid diet intake of the Orr-type reconstruction method was comparatively shorter than that of the modified Brawn Ⅰ [(4.8±2.1) d vs (7.6±2.4) d,and (9.5±3.6) d vs (11.5±3.7) d,t=-5.192,P＜0.05)].Nutritional status (weight,hemoglobin,total serum proteins and serum albumin) at 6 months after operation showed no significant differences between the two methods.But constituent ratio of Visick scores Ⅰ-Ⅱ of Orr-type was bigger than that of modified Brawn Ⅰ (86.7％ vs 62.5％,x2 =5.063,P＞0.05).Conclusions Orr-type Roux-en-Y reconstruction method can avoid reflux esophagitis,and the procedure is more simple than the modified Brawn Ⅰ method.Therefore,Orr-type Roux-en-Y reconstruction should be recommended as an adoptable method of digestive reconstruction after total gastrectomy for gastric cancer in the elderly patients.

Objective To evaluate the clinical effects of amino acid-based formulae (AAF) combined with rice oil in treating children with persistent diarrhea caused by cow's milk protein allergy (CMPA).Methods We selected 60 infants (6-12 months) with CMPA-induced persistent diarrhea treated in Tianjin Children's Hospital between April 2011 and December 2013 and divided them into control group (n =30) and observation group (n =30) with a random number table.The control group was given AAF treatment,while the observation group was given the combination treatment of AAF + rice oil The two groups were compared in terms of treatment efficiency,period before improvement of stools,antidiarrheal time,early adverse reactions (vomit,abdominal distension),and the period before disappearance of systemic symptoms (frequent crying).Results The effective rate was 89.3％ in the control group and 96.7％ in the observation group,with no statistically significant difference (P =0.267).Adverse reactions disappeared significantly earlier in the observation group than in the control group [abdominal distension:(7.2 ± 1.7) days vs.(9.4 ±2.3) days; vomit:(8.6 ±2.5) days vs.(12.5 ±2.0) days; frequent crying:(8.0 ± 1.6) days vs.(10.0 ± 2.1) days; all P =0.000].Conclusions AAF is the first choice to treat CMPA-induced diarrhea.Early use of AAF in combination with rice oil could achieve better feeding tolerance in infant with CMPA-induced diarrhea.

Objective To study the effect of rice oil on secretory immunoglobulin A (sIgA) content in feces and disease outcome in children with acute diarrhea.Methods We selected 180 children with acute diarrhea hospitalized in Tianjin Children's Hospital during the period from January 2013 to October 2014.They were randomly divided with a random number table into rice oil group,montmorillonite powder group and control group (all n =60).The effect of treatment,duration before subsiding of diarrhea and vomit,length of hospital stay and sIgA content in feces before and after treatment were analyzed.Results The total effective rates in the rice oil group and the montmorillonite powder group (93.3％,96.7％) were significantly higher than that in the control group (76.7％,P =0.011,P =0.001).Length of hospital stay,duration before subsiding of diarrhea and vomit in the rice oil group and the montmorillonite powder group were significantly shorter than those in the control group[(5.6±1.4) d,(5.7±1.6) d vs.(6.9±1.8) d;(3.7±0.9) d,(3.5±0.9) d vs.(5.4±1.2) d;(2.8 ± 0.6) d,(3.2 ± 0.8) d vs.(5.1 ± 0.8) d;all P =0.000].The total effective rates,length of hospital stay,duration before subsiding of diarrhea showed no statistically significant differences between the rice oil group and the montmorillonite powder group (P =0.402,0.716,0.226),but the duration before subsiding of vomit in the rice oil group was significantly shorter than that in the montmorillonite powder group (P =0.016).Before treatment,the sIgA contents in feces in the control group,the montmorillonite powder group,the rice oil group were 0.527 ± 0.133,0.487 ± 0.109,0.534 ± 0.150,with no significant difference (P ＞ 0.05).Two days after treatment,sIgA contents in the rice oil group and the montmorillonite powder group (0.669 ±0.176,0.612 ± 0.161) were significantly higher than in the control group (0.541 ±0.149,P =0.000,0.014).There was no significant difference between the montmorillonite powder group and the rice oil group (P =0.067).Four days after treatment,sIgA content in the montmorillonite powder group (1.981 ±0.462) was significantly higher than in the control group (1.762 ±0.378,P =0.005),while sIgA content in the rice oil group (2.331 ± 0.494) was significantly higher than in the other 2 groups (P =0.000).Compared with the levels before treatment,sIgA content 2 days after treatment was not significantly changed in the control group (P =0.295),but was significantly elevated in the montmorillonite powder group and the rice oil group (both P =0.000).sIgA contents of all the three groups 4 days after treatment were significantly higher than the contents 2 days after treatment (all P =0.000).Conclusion The effect of rice oil on acute diarrhea in children is as same as that of montmorillonite powder,and may be better in mitigating vomit and promoting the secretion of intestinal sIgA.

Objective To evaluate the effectiveness offour in onenutrition management mode in the treatment of type 1 diabetes mellitus (T1DM) in children. Methods Ninety children diagnosed with T1DM in Tianjin Children's Hospital were selected during March 2011 to June 2013. Segmented balanced random method was used to generate a random number timer, and the children were divided into intervention group and control group (n=45) by random letters. The patients in the intervention group were treated withFour in one nutrition management. Those in the control group were treated with traditional nutrition education method. Observation period was one year. The change of food choices of the parents was assessed before and after the intervention. Nutritional treatment compliance of children,fasting plasma glucose (FPG),2 hours postpransial glucose (2 hPG),and hemoglobin A1c (HbA1c) levels and complications, and so on were also evaluated. Results One year after intervention, the percentages of parents who chose low glycemic index food (41/45), vegetables and fruits consumed every day (40/45), often ate soy products(41/45), did not drunk carbonated drinks (43/45) of treatment group were significantly higher than those of control group (24/45, 20/45, 19/45, 26/45, P all<0.001);diet treatment compliance of children in treatment group was significantly better than that of the control group (P=0.000 2);FPG, 2 hPG, HbA1c of two groups of children decreased significantly than before. FPG[(8.11 ± 2.82) mmol/L], 2 hPG [(12.82 ± 1.05) mmol/L], HbA1c [(6.10±0.93)%] of treatment group were significantly lower than those of the control group [(11.71± 2.75) mmol/L, (13.77±1.49) mmol/L, (9.02±0.93)%;t=6.13, 1.66, 14.89;P<0.001 for all comparisons]. After treatment, 14 cases of treatment group had acute ketoacidosis and hypoglycemia , while 39 cases of control group had these complications (P=0.000 00). Readmission occurred in 11 cases of treatment group and 33 of the control group (P=0.000 00). Conclusions Four in onenutrition management mode was effective in the management of children with T1DM.

Objective:To investigate the characteristics of gene mutations in colorectal cancer(CRC)patients by using next-generation generation sequencing(NGS).Methods:Blood and tissue samples were collected from 90 CRC patients admitted to Beijing Hospital between August 5, 2016 and December 29, 2020.Analysis of driver gene mutations was performed by using a 1021-gene NGS panel.Results:There were 43 tissue samples and 83 blood samples.Also, 36 patients had both tissue and blood samples.The frequency rates of KRAS and BRAF mutations were 51.2%(22/43)and 20.9%(9/43)in tissue samples, and 3 rare concomitant KRAS/ BRAF mutations were detected.The frequency rates of KRAS and BRAF mutations were 26.5%(22/83)and 10.8%(9/83)in blood samples.In patients with tissue and blood samples, the rates of KRAS and BRAF mutations were 52.8%(19/36)and 10.8%(8/36). Conclusions:The rate of KRAS mutations in tissue samples from colorectal cancer patients is similar to rates reported in the literature, but the rate of BRAF mutation and the rate of rare KRAS and BRAF co-mutations are higher than those reported from other countries.

OBJECTIVETo investigate the risk of postoperative complications in elderly colorectal cancer patients over 65 years with comorbid cardiovascular diseases.

METHODSA total of 381 elderly colorectal cancer patients over 65 years were pathologically diagnosed as colorectal adenocarcinoma and underwent the first surgery in Beijing Hospital during January 2013 and December 2014. Patients were divided into comorbid cardiovascular disease group (258 cases) and non-cardiovascular disease group (123 cases) according to the existence of comorbid cardiovascular disease. The morbidity of postoperative complication was compared between two groups.

RESULTSThere was no significant difference in the morbidity of postoperative complication between two groups [27.9%(72/258) vs. 29.3%(36/123), P>0.05]. According to the Clavien-Dindo classification of postoperative complications, the morbidities of complication at all levels between two groups were not significantly different(all P>0.05). But in terms of cardiovascular complications, the morbidity of comorbid cardiovascular disease group was significantly higher than that of non-cardiovascular disease group [7.4%(19/258) vs. 0.8%(1/123), χ=6.678, P=0.010], while no significant differences in pulmonary and abdominal complications were found between two groups(all P>0.05). The morbidities of other complications (deep vein thrombosis, urinary tract infection and renal complications, etc.) of comorbid cardiovascular disease group were lower than those in non-cardiovascular disease group [2.7%(7/258) vs. 8.1%(10/123), χ=5.733, P=0.017]. Different types of cardiovascular diseases, different levels of cardiac risk index and American Society of Anesthesiologists(ASA) rating were not significantly related to the patient's occurrence of postoperative complications(all P>0.05).

CONCLUSIONSSurgery treatment for elderly colorectal cancer patients over 65 years with comorbid cardiovascular diseases is safe. However, strict cardiovascular monitoring should be performed and necessary measures should be carried out in time.

Adenocarcinoma ; complications ; surgery ; Aged ; Aged, 80 and over ; Cardiovascular Diseases ; complications ; Colorectal Neoplasms ; complications ; surgery ; Comorbidity ; Digestive System Surgical Procedures ; adverse effects ; Female ; Humans ; Male ; Postoperative Complications ; epidemiology ; Risk Factors

As the research of traditional Chinese medicine （TCM） on knee osteoarthritis （KOA） is progressing， researchers have discovered that a variety of Chinese medicines can delay the progress of KOA by regulating signaling pathways at the molecular level. The Chinese medicines and their active ingredients mentioned in this article are associated with the signaling pathways in KOA. They can regulate the levels of targeted molecules via different signaling pathways to inhibit cartilage inflammatory cytokine， apoptosis， and cartilage matrix degradation and promote chondrocyte autophagy， so as to reduce the synovial inflammatory edema and delay cartilage degeneration. This paper systematically reviews the studies about the TCM intervention of KOA. Baicalein can reduce the inflammatory cytokines and apoptosis and promote the autophagy of chondrocytes by blocking the phosphatidylinositol-3 kinase/protein kinase （PI3K/Akt） signaling pathway. Cornuside I can decrease the phosphorylation activity of Janus kinase 2/signal transducer and activator of transcription 3 （JAK2/STAT3） pathway to reduce synovial inflammation and delay cartilage matrix degeneration. Salvianolic acid A can reduce inflammation and cartilage matrix degradation by inhibiting the phosphorylation of the nuclear factor-κB （NF-κB） pathway. Emodin can reduce the activity of Wnt/β-catenin pathway to inhibit the decomposition of collagen and proteoglycan. Myristicoside can inhibit apoptosis by blocking the p38 mitogen-activated protein kinase （p38 MAPK） signaling pathway. Akebia saponin D can enhance the activity of nuclear factor E₂-related factor 2/heme oxygenase 1（Nrf2/HO-1） pathway to inhibit oxidative stress in chondrocytes. The saponins in Achyranthis Bidentatae Radix reduce cartilage matrix degradation by enhancing the transforming growth factor-β （TGF-β）/Smad signaling pathway. Crocin inhibits the cartilage inflammation and apoptosis factor increase by stimulating the activity of hippo-Yes-associated protein （Hippo-YAP）. Ligustrazine blocks the Notch pathway to improve the morphology and abnormality of chondrocytes. Oleanolic acid reduces the destruction and degeneration of cartilage matrix via the estrogen signaling pathway. The above summary aims to provide references for future clinical and experimental research on KOA.

The aqueous two-phase system (ATPS) is an all-aqueous system fabricated from two immiscible aqueous phases. It is spontaneously assembled through physical liquid-liquid phase separation (LLPS) and can create suitable templates like the multicompartment of the intracellular environment. Delicate structures containing multiple compartments make it possible to endow materials with advanced functions. Due to the properties of ATPSs, ATPS-based drug delivery systems exhibit excellent biocompatibility, extraordinary loading efficiency, and intelligently controlled content release, which are particularly advantageous for delivering drugs in vivo. Therefore, we will systematically review and evaluate ATPSs as an ideal drug delivery system. Based on the basic mechanisms and influencing factors in forming ATPSs, the transformation of ATPSs into valuable biomaterials is described. Afterward, we concentrate on the most recent cutting-edge research on ATPS-based delivery systems. Finally, the potential for further collaborations between ATPS-based drug-carrying biomaterials and disease diagnosis and treatment is also explored.