Objective:To investigate the early diagnosis value of neutrophilic CD 64 index(nCD64 ID),neutrophilic CD32 index( nCD32 ID) in ascites and CRP in blood of liver cirrhosis patients combined with spontaneous bacterial peritonitis. Methods:The data of 156 cases with liver cirrhosis was analyzed retrospectively, which CD32 index, CD64 index and CRP were detected respectively and ROC curve analysis were performed. Results:The nCD64 ID,nCD32 ID and CRP in bacterial infection group were all significantly higher than that in no infection group(P<0. 001). The sensitivity and specificity of nCD32 ID,nCD64 ID and CRP were 82. 8%,96. 2%,72. 5% and 81. 0%, 95. 8%, 73. 1% respectively. Conclusion: The sensitivity and specificity of nCD64 ID were higher than nCD32 ID and CRP. The nCD64 ID can be used as an effective index for early diagnosis and differential diagnosis of liver cirrhosis combined with spontaneous bacterial peritonitis.

This paper introduces such instrumental induced abortions without vacuum aspiration in China as rotary instrument-induced abortion, ultrasound termination pregnancy, acupuncture antiearly pregnancy and microwave radiation induced abortion. This paper can be referred to when new abortion method and apparatus developed.

Objective To investigate the safety and feasibility of en-bloc resection of a primary sacral chordona based on a 3-dimensional printing model.Methods 31 patients with primary sacral chordoma underwent en-bloc resection via a onestage posterior approach or combined anterior and posterior approaches in our oncology department from January 2013 to December 2014.They comprised 21 males and 10 females of mean age (49.2±12.5) years (range,26-67 years).Preoperative 3-D printing models were created by 3D printing technology,it included tumor tissue,the around vascular and nerves involved in sacral chordoma.The sacral chordomas were en-bloc resection with decompression and internal fixation.Results With the mean (29.0±6.8)months follow-up (range from 19 to 41),all patients underwent en bloc excision via 26 cases with posterior approach,5 cases combined posterior and anterior approaches in one stage.The mean operative time and estimated blood loss were (275.0±58.1) min and (3 250.0±1 304.4) ml,respectively.The visual analogue scale (VAS) score was (5.6±1.9) in average (range from 3 to 9) at preoperation,and (2.0±1.5) at post-operation,which was significantly lower than that of preoperation,and the pain was relief obviously.There were 13 cases in grade C,11 cases in grade D,7 cases in grade E of American Spinal Injury Association (ASIA) grade neurological function before surgery,compared with the pre-operation,there were 5 cases in grade C,6 cases in grade D,20 cases in grade E of post-operation,which was significantly improved.MSTS (Musculoskeletal Tumor Society) 93 score was 6-29 points (20.0％-96.7％) at the follow-up 3 months after surgery,with the average of (19.8 ± 5.8) points,which excellent in 8 cases,good in 14 cases,general in 5 cases,poor in 4 cases.Two cases of dysporia for the reasons of resecting on one side of the S1,2 nerve roots involved by the sacral chordoma,after sacrificing the nerve root of complete tumor resection,the urine left dysfunctional,while the pain of other 29 patients were thoroughly relief after surgery.The ones were relieved with the disturbance of sensation of the perineum before the operation.2 cases were recovery of leakage of cerebrospinal by the drainage of lumbar cistern with normal temperature.One hypostatic pneumonia patient was cured by anti-inflammatory.One with the urinary infection got better by the effective bladder irrigation,which had diabetics mellitus with the bladder stoma before.1 case of skin necrosis due to vascular thrombosis before operation,recevied flap translocation half month after surgery,got recovery 3 months later.Only one underwent tumor resection for the recurrence at 15 months follow-up.Conclusion It is feasible and safe to perform en bloc resection of primary sacral chordoma.This is the most effective means of managing method of the marginal resection of the tumor.Preoperative 3-D printing modeling enables better anatomical understanding of the relationship between the tumor,and can avoid vascular and nerves tissue injury,which can also assist in planning the surgical procedure,and be worth recommendation.

Objective To investigate the relationship of obesity and vascular endothelial growth factor (VEGF)and the clinicopathological characteristics and prognosis of breast cancer.Methods From Jan.2013 to Dec.2015,147 breast cancer patients were treated at the Department of Breast Surgery in Jiangsu University Affiliated People's Hospital.The clinical factors such as BMI,clinicopathological data and survival prognosis were collected.The chi-square test was used to analyze the association between factors and obesity.Log-rank test and COX regression analysis were performed to make univariate and multivariate analysis.The Oncomine and Kaplan Meier plotter were employed to assess the expression of VEGF in breast cancer and its association with survival prognosis of breast cancer patients.Results The median follow-up time was 40 (ranging from 12 to 58) months.Obesity was associated with tumor size(x2=11.009,P=0.001),and there was no significant correlation between axillary lymph node status,hormone receptor and Her-2 expression.The results of single factor analysis suggested that obesity and axillary lymph node status significantly affected the breast cancer patients OS (P=0.035,P=0.038)and RFS (P=0.035,P=0.036)).Cox multivariate regression analysis results suggested that obesity could be considered as an independent prognostic factor of breast cancer:P=0.051,HR=3.849 (95％ CI:0.995-14.895);Oncomine database analysis found that VEGF was relatively high in breast cancer tissue compared to that in adjacent tissues.Kaplan Meier plotter analysis results showed better overall survival (OS)and recurrence free survival (RFS)in patients with low expression of VEGF in breast cancer tissues.Conclusions Obesity is an adverse prognostic factor in breast cancer patients,and may be associated with elevated VEGF.Weight control may improve the prognosis of breast cancer patients.

Objective:To explore the effect of epalrestat combined with calcium dobesilate on cardiovascular and cerebrovascular diseases and oxidative stress in diabetes patients with peripheral neuropathy.Methods:In a retrospective analysis, 92 patients with diabetic peripheral neuropathy were admitted to the Department of Endocrinology and Metabolism Hospital of Bozhou People’s Hospital from Jun. 2018 to Jun. 2021, which were divided into observation group and control group according to the different treatment methods, with 46 cases in each group. The control group were treated with epalrestat. On this basis, the observation group were given calcium dobesilate combined treatment. The two groups were compared in terms of the Michigan diabetes neuropathy score (MDNS) Michigan neuropathy screening instrument (MNSI) score, oxidative stress reaction [serum superoxide dismutase (SOD), reduced glutathione (GSH) ], clinical efficacy, complications and adverse reactions Using t-test and chi square test.Result:After treatment, the MDNS and MNSI scores of both groups decreased, and the observation group [ (23.49±3.73), (8.49±1.97) ] were lower than the control group [ (28.49±3.85), (11.53±2.28) ] ( t=8.337, 6.843, P<0.05) ; After treatment, the levels of SOD and GSH in both groups increased compared to those before treatment, and the observation group [ (38.96±4.89), (89.79±6.92) ] were higher than the control group those [ (36.42±4.61), (86.74±6.20) ] ( t=2.563, 2.226, P=0.012, 0.028) ; The clinical efficacy of the observation group was higher than that of the control group ( Z=1.592, P=0.042) ; The incidence of complications in the observation group after 1 year was significantly lower than that in the control group ( χ2=4.389, P=0.036) ; The incidence of adverse reactions in the observation group was slightly lower than that in the control group ( χ2=0.155, P=0.694) . Conclusion:Epalrestat combined with calcium dobesilate is effective in the treatment of diabetes peripheral neuropathy, can effectively reduce complications, and has high treatment safety, which is worthy of clinical application.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.