Objective:To explore the expression of R-spondin family in colorectal cancer tissues and adjacent tissues,and to evaluate its relationship with clinic-pathological stage.Methods:A total of 64 samples of colorectal cancer tissues and adjacent tissues were collected from the patients,who received radical surgery in Xiangya Hospital,Central South University between January 2014 and August 2014.The mRNA and protein expression levels of R-spondin 1-4 and β-catenin in the colorectal cancer tissues and adjacent tissues were detected by qRT-PCR and immunohistochemistry.The relationship between the expression level of R-spondin 1-4 and the clinic-pathological factors were analyzed to explore the correlation between the expression level of R-spondin 1-4 and β-catenin in colorectal cancer.Results:Compared with the adjacent tissues,the mRNA and protein expression levels of R-spondin 1 were elevated in the colorectal cancer tissues (P＜0.05).The mRNA and protein expression levels of R-spondin 2-4 were increased in the colorectal cancer tissues than those in the normal tissues (P＜0.05),but there was no significant difference between the colorectal cancer tissues and adjacent tissues (P＞0.05).The expression level of R-spondin i was positively correlated with the nuclear expression of β-catenin in the colorectal cancer tissues (r=0.6307,P＜0.05).Conclusion:Compared with the adjacent tissues,the mRNA and protein expression levels of R-spondin 1 are significantly elevated in the colorectal cancer tissues.R-spondin 1 may play a role in promoting carcinogenesis by regulating the activity of β-catenin in the downstream of Wnt signaling pathway.

Objective To study the impact of the off-pump coronary artery bypass compared to the on-pump coronary artery bypass technique on the rate of acute kidney injury.Methods A retrospective analysis of 824 patients accepted coronary artery bypass surgery in FuWai Hospital Surgical ICU from March 2011 to January 2013.Patients were divided into two groups according to the surgical approach,597 patients in on-pump group and 227 patients in off-pump group.Then compared the difference of acute kidney injury incidence in the two groups.Results 92 patients in the on-pump group occurred AKI,the incidence of AKI was 15.4％.32 patients in the off-pump group occurred AKI,the incidence of AKI was 14.1％.Two groups of patients had no statistical difference in the incidence of AKI,x2 =0.222,P =0.638.Based on the preoperative baseline creatinine clearance levels.We defined normal creatinine clearance (SCR ≥ 60 ml/min),mild renal insufficiency (45 ml/min ＜ SCR ＜60 ml/min),moderate renal dysfunction group(31 ml/min ＜ SCR ＜45 ml/min).Decline with the preoperative creatinine clearance rate,the AKI incidence was elevated significantly,P ＜0.05.Patients with moderate renal insufficiency,offpump patients had lower incidence of AKI than those in on-pump group,P ＜ 0.05.The incidence of renal replacement in the two group patients had no statistical differences.Conclusion The incidence of AKI after coronary artery bypass surgery had no statistical differences with or without pump.In the patients with preoperative moderate renal insufficiency,off-pump can reduce the incidence of AKI,but could not change the kidney the incidence of renal replacement treatment.

Objective:To analyze the risk factors for postoperative delirium in cardiac surgery through an observational cohort study.Methods:Data of postoperative cardiac surgery patients (1 562 cases)who underwent median open-heart extracorporeal circulation between January 2020 and April 2021 at Fuwai Hospital were prospectively included, and patients were divided into delirium group(503 cases, 32.2%) and non-delirium group(1 059 cases, 67.8%) according to whether delirium occurred after surgery, and clinical indicators of the two groups were compared preoperatively, intraoperatively and postoperatively to determine the risk factors for postoperative delirium.Results:The first 48 h after surgery was the high incidence of delirium, accounting for 87.2% of the total incidence of delirium. The incidence of postoperative delirium varied widely among patients with different types of cardiac surgery. The percentage of unemployment and joblessness was higher in delirium group (7.3% vs. 4.8%, P<0.05), and the percentage of hypertension and carotid stenosis were higher than those in non-delirium group( P<0.05). Statistical differences existed between the type of surgery, intraoperative extracorporeal circulation time and block time, and intraoperative hypotensive events (MAP<40 mmHg, 1 mmHg=0.133 kPa), P<0.05. The first postoperative blood glucose was higher in delirium group , and the first blood gas partial pressure of oxygen and the first postoperative ultrasound left ventricular ejection fraction were lower than those in non-delirium group( P<0.05). There was no statistical difference in the duration of postoperative mechanical ventilation between the two groups( P>0.05), but the mean ICU stay was higher in delirium group ( P<0.05). The in-hospital mortality rate , the incidence of postoperative respiratory complications, and the mean hospitalization cost were also higher in delirium group than those in non-delirium group ( P<0.05). Multifactorial logistic regression analysis showed that carotid stenosis, preoperative hypertension, intraoperative block time >120 min and first postoperative blood glucose were independent risk factors for postoperative cardiac delirium. Conclusion:Carotid stenosis, preoperative hypertension, intraoperative block time >120 min and first postoperative blood glucose were independent risk factors for postoperative cardiac delirium.

To explore the association of nucleotide binding oligomerization domain-like receptor family caspase recruitment domain containing 3 (NLRC3) with prognosis and tumor immunity in patients with stage III colorectal cancer.
 Methods: Data of 122 patients with stage III colorectal cancer, who underwent radical resection from 2012 to 2013 in Xiangya Hospital of Central South University, were retrospectively collected. The expressions of NLRC3 and CD8+ were examined by immumohistochemical (IHC) staining. The preoperative clinical data were used to obtain neutrophil to lymphocyte ratio (NLR), and the stability of microsatellite was determined. The relationship between NLRC3 and clinicopathological factors was analyzed by χ2 test, and the independent prognostic factors for patients with stage III colorectal cancer were determined by COX regression model.
 Results: The expression of NLRC3 was significantly associated with CD8+ T cells infiltration (χ2=27.79, P<0.01), NLR (χ2=6.35, P<0.05), lymph node metastasis (LN) (χ2=10.12, P<0.01) and microsatellite stability (χ2=6.05, P<0.05). NLRC3 (OR=0.066, 95% CI 0.020 to 0.218), vascular emboli (OR=3.119, 95% CI 1.547 to 6.286) and NLR (OR=5.103, 95% CI 2.465 to 10.563) had an effect on overall survival (OS) for patients with stage III colorectal cancer (all P<0.05). In addition, NLRC3 (OR=0.144, 95% CI 0.055 to 0.377), vascular emboli (OR=3.589, 95% CI 1.859 to 6.932) and NLR (OR=2.939, 95% CI 1.509 to 5.723) also had an effect on disease-free survival (DFS) for patients with stage III colorectal cancer (all P<0.05).
 Conclusion: NLRC3, intravascular emboli and NLR are independent prognostic factors for patients with stage III colorectal cancer. NLRC3 might be a good prognostic factor for patients with stage III colorectal cancer due to its capacity of inhibiting systemic inflammation and promoting local anti-tumor immunity.
Colorectal Neoplasms ; Humans ; Intercellular Signaling Peptides and Proteins ; metabolism ; Lymphocytes ; Neoplasm Staging ; Neutrophils ; Prognosis ; Retrospective Studies