Objective To investigate the expression and significance of Syndecan-1 and E-Cadherin proteins in human sporadic colorectal carcinoma(SCC). Methods Immunohistochemical SP method was used to determine the expression of Syndecan-1 and E-Cadherin in 52 cases of SCC and 18 normal colorectal tissues. Results The positive expression rates of Syndecan-1 and E-Cadherin proteins were 65.38%,100% and 61.54%, 100% in SCC and normal colorectal tissues, respectively, the difference of which between SCC and normal colorectal tissues was statistically significant(P

Objective To investigate the effect of promoter hypermethylation of O 6 methylguanine DNA methyltransferase (MGMT) gene on colorectal tumorigenesis and progression. Methods The promoter hypermethylation of O 6 methylguanine DNA methyltransferase gene was assayed in 27 sporadic colorectal adenomas, 62 sporadic colorectal carcinomas and 20 normal colorectal mucosa tissues by methylation specific PCR. At the same time, the expression of MGMT protein was studied in the same samples using immunohistochemistry. Results None of the normal colorectal mucosa tissues showed methylated bands. Promoter hypermethylation was detected in 40.7%(11/27) of adenomas and 43.5% (27/62) of carcinomas, respectively. MGMT proteins were expressed in nucleus and cytoplasm of normal colorectal mucosa tissues. Loss of MGMT expression was found in 22.2% (6/27) of adenomas and 45.2% (28/62) of carcinomas, respectively. There were significant difference among them ( P =0.041). Methylation was detected in 5 of the 6 adenomas( P =0.027) and 24 of the 28 carcinomas( P

Objective To observe the therapeutic effect of extracorporeal shock wave therapy on the pain caused by soft tissue injury.MethodsThere were 63 cases with tennis elbow, 106 cases with frozen shoulder, and 45 cases with the pain syndrome. All the 214 cases were divide into study group and control group, 107 cases in each group. The study group received extracorporeal shock wave therapy around the pain point; the control group recieved partial closure, massage, and drugs treatment. Visual Analogue Scale (VAS) were assessed before and 4 weeks, 8 weeks and 12 weeks after treatment.ResultsThe scores of VAS showed no difference between the two groups before and 4 weeks after the treatment (P＞0.05). The study group improved in VAS 8 weeks and 12 weeks after the treatment compared to the control group (P＜0.01); the overall efficacy rate was higher in the study group than in the control group (P＜0.01).ConclusionExtracorporeal shock wave therapy is effective to treat the pain caused by soft tissue injury.

Objective To investigate the influence of parental compliance on the therapeutic effect of children with epilepsy.Methods Two hundred and sixty children with epilepsy and their parents admitted to the First People's Hospital of Wenling from December 2013 to June 2016 were enrolled,and the classical Morisky medication adherence questionnaire (MMAS-8) was applied to evaluate the compliance of parents for treatment of their children with epilepsy;after the patient taking drug for 3 days,fasting venous blood was collected in the morning,the concentration of the blood drug was tested and the influence of parent compliance on the blood drug concentration of the child with epilepsy was evaluated.Results In 260 patients,122 cases took karma form,and 138 cases took valproate orally.There were parents with good medication compliance in 130 cases (50％),medium medication compliance 80 cases (30.76％) and poor adherence to the doctor order in 50 cases (19.23％).In cases using medication irregularly,there were 26 cases sometimes without taking any drug (10.0％),17 patients' medication being interrupted (6.54％) and 10 cases having excessive medication (3.85％);no relationships were found between parental compliance and each of the following items,family role,occupation and age (all P ＞ 0.05);and the compliance was related to gender,indicating that women's good compliance level was higher than that of males';the education level was positively proportional to the compliance,and the compliance of parents with senior high school or above degree was higher than those with primary school and junior secondary school levels (83 cases vs.9 cases,38 cases,both P ＜ 0.01).Under situation of parents with poor compliance,their children had blood drug concentration higher or lower than proper range of drug level (high in 22 cases,low in 41 cases,higher than the result in good compliance 0 cases and 17 cases respectively),thus seriously affected the safety and efficacy of the treatment;the patients' frequency of irregular medication in parents' good compliance group was significantly lower than that in parents' poor compliance group [3.08％ (4/130) vs.72.0％ (36/50),P ＜ 0.05].Conclusion To improve the therapeutic effect of epileptic children,their parental good cooperation is necessary.

Objective To investigate the clinical value of color doppler ultrasound in the diagnosis of thrombus of lower extremity veins. Methods A total of 84 patients with thrombus of lower extremity veins(DVT) underwent color Doppler ultrasound and digital subtraction angiography (DSA), and analyzed the test results comparatively. Results Color doppler ultrasound diagnosed deep vein thrombosis(DVT) in 68 cases of all 84 patients, 49 cases were in the left low-er extremity (72.1%), 19 cases were in the right lower extremity (27.9%),patients were in the left more than in the right;In all 68 patients,39 cases were in acute stage,20 cases were in sub acute stage, 9 cases were in chronic period. DSA diagnosed lower extremity DVT in 66 cases in 68 cases diagnosed by color doppler ultrasound,DSA diagnosed lower extremity DVT in 64 cases, 4 cases that examined by DSA were negative. Color doppler ultrasound diagnosed normal in 18 cases, DSA found lower extremity DVT in 2 cases. Compared with the results of DSA examination, the sensitivity and the specificity of color doppler ultrasound for diagnosing DVT were 96.97% and 88.9%, the diagnostic consistency of both methods was high (Kappa=0.78). Conclusion Color doppler ultrasound is simple, fast and repro-ducible, it is high in consistency with DSA and has important value in the diagnosis of lower extremity DVT.

Objective:The aim of the study was to develop a transcultural adaptation of Scrub Practitioners ′ List of Intraoperative Non-technical Skills to Chinese. Methods:The translation of SPLINTS was based on the Brislin ′s translation model and expert consultation were conducted for cultural adaptation before the Chinese version was accomplished. The content validity of Chinese version scale was evaluated by Delphi method. The applicability and observer reliability of the tool was tested by behavioral observation of simulate videos. Results:The positive coefficients of experts in the first and second rounds were both 100% and the authority coefficients were 0.802 and 0.906 respectively. The concordancy coefficients of expert Kendall were 0.282-0.433( P<0.05). The results of Delphi expert consultation showed that the average content validity index (S-CVI/Ave) of the scale level was 0.93, and the item level (I-CVI) content validity index was 0.87-1.00. The rater training showed that the intra-observer reliability was 0.75-0.96 and inter-observer reliability (Kendall W) was 0.502-0.557( P<0.01). Conclusion:The cross-cultural adaptation of SPLINTS-Chinese version is scientific and reliable. The content validation and observer reliability are in-line with scale evaluation criteria. Further psychometric measurement can be conducted in the group of scrub nurses in the operating room.

Objective:To observe the incidence, risk factors of malignant brain edema (MBE) and the influence of MBE on outcomes after early successful recanalization of acute large vascular occlusion stroke (ALVOS).Methods:A total of 149 patients (age (68±11) years, male 85 (57.0%)) with ALVOS who underwent early endovascular treatment and achieved successful recanalization at the First Affiliated Hospital of Wannan Medical College from July 2014 to February 2019 were retrospectively analyzed. Baseline data, perioperative data, and 90-day prognostic information were collected from patients enrolled in the study. Univariate and multivariate analyses were used to explore the relationship between MBE and outcomes, and the risk factors of MBE.Results:Among the 149 patients, baseline National Institutes of Health Stroke Scale score was 16 (13, 20), baseline Alberta Stroke Project early CT score was 9 (8, 10), the time of onset-to-puncture was (248.3±61.3) minutes, and the onset-to-recanalization time was (312.4±69.7) minutes. MBE occurred in 23 patients (15.4%, 23/149). The 90-day favorable outcome (90-day modified Rankin Scale score≤ 2) in patients with MBE was significantly lower than those without MBE (17.4% (4/23) vs 61.1% (77/126), χ 2=14.985, P<0.001), and the 90-day mortality in patients with MBE was significantly higher than those without MBE (43.5% (10/23) vs14.3% (18/126), χ 2=10.861, P=0.003). MBE was shown to be an independent predictor of 90-day poor outcome (adjusted OR=12.078, 95 %CI 1.934-75.443, P=0.008) and death (adjusted OR=4.146, 95 %CI 1.060-16.216, P=0.041). Multivariate Logistic regression analysis showed that the collateral circulation status was related to the incidence of MBE in patients with ALVOS after successful recanalization (level 2 vs level 0, adjusted OR=0.109, 95 %CI 0.021-0.563, P=0.008). Conclusions:MBE is an independent risk factor of ALVOS patients with poor outcome or death in 90 days. For patients with ALVOS, even if the occlusive vessels have been successfully recanalized after early endovascular treatment, MBE is still not uncommon. The collateral circulation state is an independent predictive factor of the development of MBE after recanalization by early endovascular treatment in patients with ALVOS.

Objective:To investigate the early predictive factors of periprocedural thrombus migration and the relationship between periprocedural thrombus migration and prognosis after mechanical thrombectomy (MT) in stroke patients.Methods:The patients with anterior circulation acute large vessel occlusion stroke (ALVOS) who underwent MT in the Stroke Center of Yijishan Hospital of Wannan Medical College from May 2015 to December 2019 were retrospectively analyzed. The baseline characteristics, procedural and clinical outcomes were collected. Univariate and multivariate regression analysis was used to explore the risk factors of thrombus migration and the relationship between thrombus migration and prognosis of patients.Results:There were 302 ALVOS patients [(68.8±11.0) years old and 166 males (55.0%)] included, of whom thrombus migration was identified in 80 patients (26.5%), including 60 cases (75.0%) of proximal migration. Cardiogenic stroke ( OR=2.722, 95% CI 1.367-5.418, P=0.004) and clot burden score (CBS; OR=0.849, 95% CI 0.745-0.968, P=0.015) were independent risk factors of thrombus migration. Proximal migration ( OR=2.822, 95% CI 1.220-6.528, P=0.015) was an independent risk factor of 90-day clinical outcome, while the effect of distal migration on 90-day clinical outcome was not statistically significant. Conclusions:Cardiogenic stroke and lower CBS score are independent predictors of periprocedural thrombus migration in ALVOS patients who underwent MT. Proximal migration is an independent risk factor for the prognosis of patients, which has important clinical intervention significance.

Objective:To evaluate the benefits and risks of advanced age patients with acute anterior circulation large vessel occlusive stroke (ALVOS) accepted mechanical thrombectomy (MT), and explore the related influencing factors for prognoses in these patients.Methods:Six hundred and eighty patients with acute anterior circulation ALVOS accepted MT in 3 comprehensive stroke centers from January 2014 to December 2020 were sequentially collected. (1) Patients were divided into advanced age group (≥80 years old) and non-advanced age group (<80 years old) according to age, and the differences between the two groups were compared in successful postoperative vascular recanalization rate, incidence of perioperative complications, and good prognosis rate (modified Rankin scale [mRS] scores≤2) and mortality 90 d after onset. (2) Patients were divided into good prognosis group (mRS scores≤2) and poor prognosis group (mRS scores>2) according to the prognoses 90 d after onset; univariate analysis and multivariate Logistic regression analysis were used to investigate the independent factors for prognoses of the patients after MT. (3) According to the prognoses 90 d after onset, the advanced age patients were divided into good prognosis subgroup (mRS scores≤2) and poor prognosis subgroup (mRS scores>2). Univariate analysis and multivariate Logistic regression analysis were used to investigate the independent factors for prognoses of the elderly patients after MT.Results:(1) In these 680 patients, 92 patients (13.5%) were into the advanced age group and 588 patients (86.5%) were in the non-advanced age group; patients in the advanced age group had significantly lower successful recanalization rate (67.4% vs. 77.9%), significantly lower good prognosis rate 90 d after onset (20.7% vs. 50.2%), and statically higher mortality 90 d after onset (40.2% vs. 21.1%) as compared with the non-advanced age group ( P<0.05); however, there was no significant difference between the two groups in the incidences of symptomatic intracranial hemorrhage (sICH, 15.6% vs. 10.6%) and malignant cerebral edema (MCE, 12.2% vs. 17.6%, P>0.05). The baseline data of the advanced age and non-advanced age patients were further matched with propensity score matching analysis (1:1) and statistically analyzed: the 91 elderly patients had significantly lower good prognosis rate 90 d after onset (20.9% vs. 36.3%) and MCE incidence (12.4% vs. 33.3%) than the 91 non-elderly patients ( P<0.05); there was no significant differences in successful vascular recanalization rate (67.0% vs. 71.4%), sICH incidence (15.7% vs. 17.6%) or mortality 90 d after onset (39.6% vs. 37.4%) between the two groups ( P>0.05). (2) Among the 680 patients, 314 (46.2%) had good prognosis and 366 (53.8%) had poor prognosis. As compared with the good prognosis group, the poor prognosis group had significantly higher proportion of patients at advanced age, significantly lower proportion of male patients, significantly higher proportion of patients with hypertension, diabetes or atrial fibrillation, significantly lower baseline Alberta Stroke early CT (ASPECT) scores, significantly higher baseline National Institutes of Health Stroke Scale (NIHSS) scores, statistically higher proportion of patients with cardiogenic embolism, significantly lower incidence of tandem lesions, significantly shorter time from onset to sheathing, statistically higher proportion of internal carotid artery occlusion, significantly lower proportion of patients with grading 2 collateral circulation, and significantly lower proportion of successful vascular recanalization ( P<0.05). Advanced age ( OR=3.144, 95%CI: 1.675-5.900, P<0.001) was an independent factor for prognoses 90 d after MT, in addition to baseline ASPECT scores, baseline NIHSS scores, diabetes mellitus, successful recanalization, and collateral circulation grading. (3) In the advanced age group, there were 19 patients (20.7%) with good prognosis and 73 patients (79.3%) with poor prognosis. As compared with the good prognosis subgroup, the poor prognosis subgroup had significantly lower proportion of male patients, significantly lower proportion of patients with grading 2 collateral circulation or complete recanalization, and significantly higher baseline NIHSS scores ( P<0.05). Baseline NIHSS score ( OR=1.482, 95%CI: 1.187-1.850, P=0.001) was an independent factor for prognoses 90 d after MT in advanced age patients. Conclusion:Although advanced age is an independent risk factor for prognoses of patients with acute anterior circulation ALVOS accepted MT, there are still some advanced age patients benefiting from MT without increased complications, especially for those with low baseline NIHSS scores.

Objective:To explore the influence of blood pressure (BP) profiles 24 h after early endovascular treatment (EVT), including mean blood pressure and blood pressure variability, in clinical prognoses of patients with acute large vessel occlusion stroke (ALVOS) of anterior circulation 90 d after EVT.Methods:Clinical data and blood pressure profiles of patients with ALVOS of anterior circulation who received EVT in our hospital from July 2014 to February 2019 were prospectively collected. The 90-d modified Rankin scale (mRS) scores were used as clinical prognosis evaluation, and modified thrombdysis in cerebral infarction (mTICI) was used as evaluation criteria for recanalization of postoperative occlusive blood vessels. Multivariate Logistic regression analysis was used to determine the independent influencing factors for prognoses 90 d after EVT.Results:(1) Two hundred and sixteen patients were collected; 159 patients were with successful recanalization and 57 patients were with unsuccessful recanalization; 90 d after EVT, 95 patients (44%) had good prognosis and 121 patients (56%) had poor prognosis. As compared with patients in the good prognosis group, patients in the poor prognosis group had signficantly advanced age, signficantly higher proportion of patients with atrial fibrillation, signficantly higher baseline NIHSS scores, and signficantly lower baseline ASPECT scores ( P<0.05); and the differences of occlusion locus were statistically significant between patients from the good and poor prognosis groups ( P<0.05). Patients in the poor prognosis group had significantly higher baseline systolic blood pressure (SBP), mean SBP, max SBP, and significantly higher standard deviation, variable coefficient, and continuous variation of SBP, and statistically higher standard deviation, variable coefficient, and continuous variation of diastolic blood pressure (DBP) as compared with those in the good prognosis group ( P<0.05). Multivariable Logistic regression analysis showed that the standard deviation and continuous variation of SBP were independent influencing factors for clinical prognoses 90 d after EVT ( OR=1.116, 95%CI: 1.002-1.243, P=0.047; OR=1.116, 95%CI: 1.016-1.227, P=0.022). (2) In patients with successful recanalization, as compared with patients in the good prognosis subgroup, patients in the poor prognosis subgroup had signficantly advanced age, statistically higher proportions of patients with diabetes mellitus and atrial fibrillation and baseline NIHSS scores, and statistically lower baseline ASPECT scores ( P<0.05); and the differences of occlusion locus and first choices of treatment were statistically significant between patients in the good and poor prognosis subgroups ( P<0.05). Patients in the poor prognosis subgroup had significantly higher baseline SBP and max SBP, and significantly higher standard deviation, variable coefficient, and continuous variation of SBP, and statistically higher variable coefficient of DBP as compared with those in the good prognosis subgroup ( P<0.05). Multivariable Logistic regression analysis showed the standard deviation, variable coefficient, and continuous variation of SBP were independent influencing factors for clinical prognoses 90 d after EVT ( OR=1.164, 95%CI: 1.021-1.326, P=0.023; OR=1.191, 95%CI: 1.007-1.409, P=0.041; OR=1.141, 95%CI: 1.018-1.279, P=0.024). However, in patients with unsuccessful recanalization, there were no significant differences in blood pressure proliles between the good prognosis subgroup and poor prognosis subgroup ( P>0.05). Conclusion:The blood pressure variability 24 h after EVT is correlated with the clinical prognoses of patients with ALVOS of anterior circulation 90 d after EVT.