Objective To analyze the risk factors of subclavian venous catheter-related infections in patients with traumatic hemorrhagic shock (THS) and provide a basis for prevention and control of the infection. Methods A retrospective study was conducted. 357 patients with THS and indwelling of subclavian vein catheter admitted in the Department of Emergency of Affiliated Hospital of Sichuan Provincial Luzhou Medical College were enrolled, and according to the infection state, they were divided into infection group (56 cases) and non-infection group (301 cases). The patients' data of gender, age, history of underlying disease, catheter position, catheter indwelling time, time staying in hospital, situation of antimicrobial drug used, application of tracheotomy or not, white blood cell count (WBC) levels, etc were collected for univariate analysis. The resulting indexes with statistical significance were applied for carrying out the multivariate logistic regression analysis, and then the independent risk factors involved in the development of subclavian venous catheter-related infections in the shock patients could be screened out.Results In 357 patients with THS, 56 were infected (15.7%). Univariate analysis showed: age ≥ 60 years (χ2 = 19.839,P < 0.001), with diabetes mellitus in past history (χ2 = 6.252,P = 0.012), catheter indwelling time ≥ 7 days (χ2 = 19.261,P < 0.001), time staying in hospital ≥ 7 days (χ2 = 4.315,P = 0.038), time for use of antimicrobial drug≥ 7 days (χ2 = 16.161,P < 0.001), tracheotomy (χ2 = 40.969,P < 0.001), WBC < 4×109/L (χ2 = 39.451,P < 0.001) and the disease severity grade 4 - 5 (χ2 = 8.345,P = 0.004) were the risk factors of subclavian venous catheter-related infections in patients with THS. Multivariate analysis showed: catheter indwelling time ≥ 7 day [odds ratio (OR) = 16.713, 95% confidence interval (95%CI) 3.651 - 76.624), tracheotomy (OR = 6.861, 95%CI 2.377 - 18.246), WBC < 4×109/L (OR = 4.903, 95%CI 1.887 - 12.643) were the independent risk factors of subclavian venous catheter-related infections in THS patients.Conclusion The strict implementation of aseptic catheterization, shortening the time of catheter indwelling as much as possible and the rational use of antibiotics can effectively reduce and prevent the incidence of venous catheter-related infection in THS patients.

Objective:To investigate the effect of 253 lymph node dissection on postoperative recovery and prognosis of rectal cancer patients in different stages undergoing radical resection.Methods:A total of 232 rectal cancer patients undergoing radical resection in the Fourth Hospital of Hebei Medical University between January 2013 and December 2014 were enrolled and divided into the 253 lymph node dissection group(all cases underwent surgery in 2014)and the non-dissection group(all cases underwent surgery in 2013). Differences in age, sex, tumor differentiation and depth of invasion was analyzed between the two groups.Based on clinicopathological data, each group was further divided into three subgroups(Ⅰ, Ⅱ, Ⅲ). Postoperative recovery assessment included the time of the earliest flatulence, the time of first feeding, the duration of hospitalization and anastomotic leakage.In addition, postoperative survival parameters were also analyzed.Results:Compared with non-dissection group, patients in the 253 lymph node dissection group had similar overall postoperative recovery and rates of complications( P>0.05), but significantly longer survival( P=0.012). Besides, 253 lymph node dissection had a beneficial effect on prognosis for those in the stage Ⅲ subgroup( P=0.039), and did not affect the prognosis for those in the stage Ⅰ and Ⅱ subgroups( P>0.05). Conclusions:For rectal cancer patients undergoing radical resection, 253 lymph node dissection does not affect postoperative recovery, but offers improved prognosis for stage Ⅲ patients.We should perform 253 lymph node dissections on all rectal cancer patients when the clinicopathological staging is unknown.

Objective To investigate the effect of knockdown or overexpression of G6PD on proliferation, growth and migration of human hepatocellular carcinoma cell PLC/PRF/5. Methods Lentivirus-mediated knock-down or overexpression of G6PD was achieved in human hepatocellular carcinoma cell line PLC/PRF/5. RT-PCR and Western blotting assay were used to detect the overexpression or knockdown of G6PD.Cell proliferation and mi-gration curves were recorded by real-time cell analysis system(RTCA),the cell proportion in the DNA replication phase can be directly displayed with EDU experiment,cell growth ability was detected by colony forming assay. Results The doubling time of cells in G6PD knockdown group was longer than that of the control group,and the cell growth rate decreased significantly,the proportion of cells in proliferative phase(43.2%)was lower than that in the control group,but the rates colony formation and migration were significantly decreased(P<0.05,respective-ly),and the migration curves separated apparently.While no significant differences in proliferation,growth and mi-gration of PLC/PRF/5 cells were found between the over-expressed strain and the control group. Conclusion The reduction of G6PD expression in HCC cells inhibits the proliferation and growth of HCC,which may lay a foun-dation for the further study of the pathogenesis and treatment of HCC.

Objective To compare and analyze the primary and secondary structures and antigenic epitopes of the two allergens: Der p 2 and Der f 2. Methods The protein sequences of Der p 2 and Der f 2 were downloaded online. The primary and secondary structures of the dust mite allergens were compared and analyzed bioinformatically to determine the potential epitope and signal peptide sites. Results Both Der p 2 and Der f 2 contained 146 amino acids and 9 potential protein binding sites with a secondary structure that mainly contains [3 - sheets, and there might be signal peptides site at the 1st 17th segment of the N - terminus. B cell epitopes analysis revealed that both Der p 2 and Der f 2 have 9 potential linear B epitopes and 2 conformational B epitopes. NetMHCⅡserver prediction showed Der p 2 contains 6 high affinity sites, whereas Der f 2 0nly contains 5. Conclusion This study may lay the foundation for further research of the biochemical function of the 2 allergens and contribute to vaccine development for allergen - specific immunotherapy.

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.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.