Objective To evaluate the prevention and treatment effect of double-tube-drainage (DTD) method on anastomotic fistula(AF) after surgery of rectal carcinoma. Method One hundred and eight cases of rectal carcinoma with Dixon′s operation (from January 1998 to March 2005) were divided randomly into 2 groups: treatment group 52 cases underwent DTD, control group was 56 cases received a tube drainage. Results The incidence of anastomotic fistula were 1.9% and 14.3% in treatment group and control group, respectively. There was a significant difference between treatment group and control group (P

Objective To investigate the different characteristics of gastrointestinal migrating myoelectrical complex (MMC) of different origin in fasting state and the effects of motilin (MTL) and ursodeoxycholic acid (UDCA) on the MMC of the gastrointestinal tract of different origin in rats. Methods Three bipolar silver electrodes were chronically implanted on the antrum, duodenum and jejunum. Seven days later twenty-four experimental rats were divided into two groups. One group were injected with porcine MTL via sublingual vein, while the other group was perfused with UDCA into the stomach. The gastrointestinal myoelectrical activity was recorded one hour before and two hours after the test substances infusions on these conscious fasting rats. Results Among the total sixty-eight MMCs recorded in fasting rats under control, 67% started in the duodenum, and 33% started in the antrum. The MMC cycle duration and duration of phase Ⅲ of antral origin were longer than those of duodenal origin. Administration of porcine MTL could induce a premature antral phase Ⅲ of antral origin. However, perfusion into the stomach with UDCA resulted in a shorter MMC cycle duration and longer duration of phase Ⅲ of duodenal origin. Conclusion In fasting rats, MMC may originate from the antrum and duodenum, respectively. The different characteristics of MMC of different origin may contribute to the large variations within subjects. Pocrine MTL and UDCA can affect the MMC of different origin of the gastrointestinal tract in fasting state.

In order to monitor the physiological condition of the human body in daily life, this study has designed a system of measuring physiological parameters based on cushion, which could detect heart rate and respiration rate when people are sitting. The system can continuously colect signal from cushion with a state of low pressure and without sticking any electrode on people’s bodies. The hardware part mainly includes the signal acquisition circuit of the sensor, microcomputer control module and Bluetooth wireless transmission module. For the two physiological signals have the characteristic of the large noise and low-frequency, we use the Butterworth low-pass filter to process the signal according to an optimized Matlab algorithm. The results show that this system can measure heart rate and respiration rate accurately. Thus, the real-time monitoring on body’s information can be implemented.

Objective To investigate the value of electrocardiographic parameters in assessing severe coronary artery lesions in patients with coronary artery disease.Methods A total of 364 patients with coronary heart disease admitted to the Second Affiliated Hospital,Zhengzhou University from January 2022 to September 2023 were selected as the subjects.The patients were divided into severe lesion group(n=123)and non-severe lesion group(n=241)based on the Gensini score.The two groups were compared in terms of baseline data and electrocardiographic parameters.Logistic regression was used to analyze the factors affecting severe lesions and the efficacy of ECG parameters assessment.A column-line plot of ECG parameters to assess severe lesions was created.The joint incremental value of ECG parameters and the area under the ROC curve for assessing severe lesions were calculated.Results The patients in the severe lesion group were elder in age and they showed significantly higher rates in creatine kinase isoenzyme,amino-terminal brain natriuretic peptide precursor,QRS time frame,frontal QRS-T pinch angle,smoking,hypertension,diabetes mellitus,pathologic Q waves,left ventricular hyper voltage,fragmented QRS waves,and significantly lower rates in low HDL cholesterol and ejection fraction,as compared to the non-severe lesion group(all P<0.05).Logistic regression analysis showed that pathological Q waves(OR=3.71,95%CI:1.93～7.15,P<0.001),left ventricular hyper voltage(OR=5.05,95%CI:1.66～15.41,P=0.004),fragmented QRS waves(OR=2.17,95%CI:1.14～4.11,P=0.018),and frontal QRS-T pinch angle(OR=1.01,95%CI:1.00～1.02,P=0.023)were the factors for assessing severe lesions.The incremental value of combined ECG parameters for severe lesions:C-statistic 0.09(95%CI:0.02～0.16,P=0.009),NRI 0.37(95%CI:0.20～0.55,P<0.001),and IDI 0.12(95%CI:0.08～0.17,P<0.001).The ROC curves showed an AUC of 0.79(95%CI:0.74～0.84,P<0.001),a sensitivity of 63.41%,and a specificity of 85.89%for the combined assessment of severe lesions by ECG parameters.Conclusion The combined observations of electrocardiographic parameters such as pathologic Q waves,left ventricular hyper voltage,fragmented QRS waves,and frontal QRS-T pinch angle have an affirmativeclinical value in the assessment of severe lesions.

Interleukin-12 (IL-12) is a pro-inflammatory cytokine derived from antigen-presenting cells. IL-12 has a variety of effector mechanisms such as promoting T cells proliferation and cytotoxicity, inducing T cells and NK cells to secrete interferon-γ (IFN-γ), etc. IL-12 shows significant anti-tumor effect in preclinical stage and is quickly used in clinic, but its systemic administration has serious dose-limiting toxicity. At present, most of the research is about the topical use of IL-12 to reduce systemic toxicity, change tumor microenvironment and activate immune system. This article reviews the research progress and clinical trials of IL-12 in the treatment of solid tumors in recent years.

Objective To observe the clinical efficacy of Zhuanyaotang Granules for the treatment of degenerative lumbar spinal stenosis(DLSS).Methods Using a randomized double blind controlled design,104 DLSS patients were divided into an experimental group and a control group using a random number table method,with 52 patients in each group.The treatment group took oral Zhuanyaotang Granules,methylcobalamin tablets and celecoxib capsule simulants.The control group used Zhuanyaotang Granules simulants,methylcobalamin tablets and celecoxib capsules.The course of treatment was 3 weeks for both groups.The follow-ups were conducted at 1 month and 3 months after treatment.The intermittent claudication distance,visual analogue scale(VAS)score and JOA efficacy rating criteria for low back pain score were observed in both groups before treatment,1,2,3 weeks of treatment and 1 month after treatment and 3 months after treatment.Adverse reactions during treatment were recorded.Results There were 5 cases of detachment and 2 cases of exclusion in the experimental group,and 5 cases of detachment and 1 case of exclusion in the control group.Compared with before treatment,there were statistically significant differences in intermittent claudication distance,VAS score,and JOA score between the two groups of patients at various time points during treatment and follow-up(P<0.05);there was no statistically significant difference in intermittent claudication distance,VAS score,and JOA score between the experimental group and the control group before treatment and 1 and 2 weeks of treatment(P>0.05);compared with the two groups at 3 weeks of treatment and 1 and 3 months after treatment,the intermittent claudication distance and JOA score in the experimental group were lower than those in the control group(P<0.05);There was no significant difference in VAS score between the two groups and the control group after 3 weeks of treatment(P>0.05).There were 2 adverse reactions(4.4%)in the experimental group and 5 adverse reactions(10.8%)in the control group,without statistical significance(P>0.05).Conclusion Zhuanyaotang Granules can effectively relieve pain and improve lumbar function in patients with DLSS,which is more effective and safer than oral celecoxib capsules and methylcobalamin tablets.

Objective This paper aims to investigate and analyze the baseline conformity rate of bacterial culture exami-nation records in a tertiary specialized hospital.By doing this,this paper seeks to understand the current situation of medical re-cord writing of bacterial culture examination and explore the improvement path and relevant measures for enhancing the conformity rate of bacterial culture examination records.Methods According to the requirements of"Quality Control Index of Medical Re-cord Management(2021 Edition)",a retrospective analysis was conducted on 6 317 medical records that underwent bacterial culture examination in 2022.Results The execution rate of medical orders was 100.00％,the completeness rate of the report sheet was 100.00％,the record rate of medical records was 81.05％,the analysis rate of results was 33.07％,and the conformi-ty rate of bacterial culture examination records was 33.07％.Conclusion It is imperative to enhance the conformity rate of bac-terial culture examination records and improve the quality of medical records in terms of content.

Objective:To explore the predictive factors for adverse clinical outcomes in critically ill adult patients with autoimmune encephalitis by analyzing their clinical characteristics and prognosis.Methods:Clinical data of patients diagnosed with " confirmed" or " possible" autoimmune encephalitis who were hospitalized in the intensive care unit (ICU) of the Department of Neurology at the Second Xiangya Hospital of Central South University from January 2015 to December 2023 were retrospectively collected. The neurological function of patients at 3, 6, and 12 months of onset was followed up, and the modified Rankin Scale (mRS) at 12 months was used as an evaluation index for clinical prognosis; Further analysis was conducted on the relationship between clinical features, auxiliary examinations, and prognosis.Results:The 12-month survival rate of critically ill adult patients with autoimmune encephalitis in our center was 90.7%(117/129), and the 6-month poor prognosis rate was 28.7%(37/129). Univariate logistic regression analysis found that age of onset ( P<0.01), presence of tumors ( P<0.01), mechanical ventilation ( P<0.01), Glasgow Coma Scale (GCS) at ICU admission ( P<0.01), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score ( P<0.01), cerebrospinal fluid glucose ( P<0.01), cerebrospinal fluid protein level ( P=0.02), epileptic waves in electroencephalography (EEG) ( P=0.03), use of glucocorticoids ( P=0.04), and time interval between initiation of intravenous immunoglobulin (IVIG) and onset ( P=0.04) were associated with prognosis. The results of multiple logistic regression analysis showed that mechanical ventilation [ P=0.01, area under the curve (AUC)=0.72)], APACHE Ⅱ score ( P=0.04, AUC=0.68), cerebrospinal fluid protein content ( P=0.04, AUC=0.65), and the time interval between initiation of IVIG and onset ( P=0.02, AUC=0.64) were independent predictive factors for the prognosis of adult critical autoimmune encephalitis. The prognostic prediction model for adult critical autoimmune encephalitis established by combining these four indicators has a higher AUC (0.85). Conclusions:Mechanical ventilation, APACHE Ⅱ score, cerebrospinal fluid protein level, and the time interval between initiation of IVIG and onset are predictive factors for poor clinical outcomes in critically ill autoimmune encephalitis in adults; The prognostic prediction model for adult critical autoimmune encephalitis established by combining these four indicators can identify patients with poor prognosis early, which is beneficial for early comprehensive management and intervention treatment to improve patient prognosis.

Objective:To analyze the clinicopathological characteristics and intrahepatic immune cells infiltration condition after Kasai biliary atresia surgery.Methods:Data of 28 cases who underwent liver transplantation in the liver transplantation center of our hospital from June 2017 to March 2019 were enrolled. Of which, 20 cases were in the biliary atresia group (divided into two subgroups: 10 cases without Kasai surgery and 10 cases after Kasai surgery, and latter subsided cholestasis) and 8 cases in the control group. Clinical and pathological morphological characteristics of the groups were compared. Liver tissue sections were stained with immunohistochemistry and CD3, CD4, CD8, CD20, Foxp3, and interleukin-17A were quantitatively analyzed. Kruskal-Wallis test was used to measure the above indicators, and rank-sum test or Fisher's exact test was used to compare the count data.Results:The degree of clinical and pathological cholestasis in the biliary atresia group after Kasai surgery was significantly lower than that of the group without Kasai surgery, and the degree of liver fibrosis was also significantly reduced ( P < 0.05), but there was no statistically significant difference in the degree of inflammation in the portal vein area between the two groups ( P > 0.05). There was statistically significant difference in the types of immune cells infiltrated in the liver ( P < 0.05). Compared with the group without Kasai surgery, the infiltration of CD3, CD8, IL-17A and Foxp3 positive cells in the portal vein area after Kasai surgery group ( P < 0.05) was significantly reduced, but there was no statistically significant difference in the proportion of Foxp3/CD4 positive cells between the two groups ( P > 0.05), which continued to be lower than that of the control group ( P < 0.05). Compared with the non-Kasai surgery group, the proportion of Foxp3/IL-17A and Foxp3/CD8 positive cells in the portal vein area did not increase significantly after Kasai surgery group ( P > 0.05), and remained lower than the control group. However, the proportion of Foxp3/IL-17A and Foxp3/CD8 positive cells was significantly reduced ( P ??< 0.05). Conclusion:Intrahepatic inflammatory cell infiltration and regulatory/effector T lymphocyte proportion dysregulation exist in patients with subsided cholestasis after Kasai biliary atresia surgery, which may be an important factor to promote the disease progression.

Objective:To explore the impact of sleep duration, physical exercise, and their interactions on the risk of dyslipidemia in older adults aged ≥80 (the oldest old) in China.Methods:The study subjects were the oldest old from four rounds of Healthy Aging and Biomarkers Cohort Study (2008-2009, 2011-2012, 2014 and 2017-2018). The information about their demographic characteristics, lifestyles, physical examination results and others were collected, and fasting venous blood samples were collected from them for blood lipid testing. Competing risk model was used to analyze the causal associations of sleep duration and physical exercise with the risk for dyslipidemia. Restricted cubic spline (RCS) function was used to explore the dose-response relationship between sleep duration and the risk for dyslipidemia. Additive and multiplicative interaction model were used to explore the interaction of sleep duration and physical exercise on the risk for dyslipidemia.Results:The average age of 1 809 subjects was (93.1±7.7) years, 65.1% of them were women. The average sleep duration of the subjects was (8.0±2.5) hours/day, 28.1% of them had sleep duration for less than 7 hours/day, and 27.2% had sleep for duration more than 9 hours/day at baseline survey. During the 9-year cumulative follow-up of 6 150.6 person years (follow-up of average 3.4 years for one person), there were 304 new cases of dyslipidemia, with an incidence density of 4 942.6/100 000 person years. The results of competitive risk model analysis showed that compared with those who slept for 7-9 hours/day, the risk for dyslipidemia in oldest old with sleep duration >9 hours/day increased by 22% ( HR=1.22, 95% CI: 1.07-1.39). Compared with the oldest old having no physical exercise, the risk for dyslipidemia in the oldest old having physical exercise decreased by 33% ( HR=0.67, 95% CI: 0.57-0.78). The RCS function showed a linear positive dose-response relationship between sleep duration and the risk for hyperlipidemia. The interaction analysis showed that physical exercise and sleep duration had an antagonistic effect on the risk for hyperlipidemia. Conclusion:Physical exercise could reduce the adverse effects of prolonged sleep on blood lipids in the oldest old.