Objective To explore the effect of type 2 diabetes mellitus(T2DM) on vascular damage characteristics of acute cerebral infarction and the impact on the short term prognosis.Methods One hundred and fifty-six cases of acute cerebral infarction patients were selected and divided into the T2DM group with 64 cases and non-T2DM group with 92 examples.According to the whole cerebral angiogram,the results and the results of the treatment of acute cerebral infarction and prognosis were analyzed.Results The incidence of intracranial artery stenosis of the T2DM group was 79.69％ (51/64),of non-T2DM group was 58.70％ (54/92),the difference between two groups was significant(x2=12.856,P＜0.05).The incidence of before andafter intracranial artery stenosis coexist,circulation narrow coexist in T2DM group was 50.00％ (32/64),59.36％(38/64) respectively,in non-T2DM group was 21.74％(20/92),29.35％(27/92) respectively,the difference between groups was significant(x2 =9.652,8.659;P＜0.05).The incidence of multivessel lesions and diffuse lesions and without collateral compensatory in T2DM group was 71.88％ (46/64),65.63％ (42/64) and 71.88％(46/64) respsctively,in non-T2DM group was 54.35％(59/92),39.13％(36/92) and 31.52％(29/92) respectively,thedifference between groups was significant(x2=8.625,9.354,11.053;P＜0.05).The total effective rate after 2 weeks of treatment in T2DM group was 46.88％(30/64),in non-T2DM group was 90.22％(83/92),the difference between groups was significant(x2=8.061,P＜0.05).Conclusion The incidence of intracranial artery stenosis in patients with intracranial artery stenosis combined with T2DM is higher than the control group,and lesion range widely,diffuse damage,vascular damage moderately severe stenosis and occlusion are significantly higher than in non-T2DM group,especially without collateral compensatory rates is higher than non-T2DM group,while the neural function damage of T2DM group is heavier and poorer prognosis.

Objective To evaluate the influence of fast-track surgery in perioperative period on the clinical outcomes of patients at nutritional risk in respectable esophageal cancer surgery perioperatively.Methods A total of 170 esophageal carcinoma patients receiving radical operation in our hospital from January 2008 to December 2013 were randomly divided into two groups by simple random method (n =85 each):one group was treated with the new concept of FTS-based on nutritional risk screening (FTS group),and the other control group received conventional perioperative management (CPM group).The postoperative first passage of flatus and defecation,time to drainage tube removal,postoperative hospital stay,and morbidity of the postoperative complication were recorded and compared.Results The time to drainage tube removal and length of postoperative hospital stay were significantly lower in the FTS group than those in the CPM group,and the overall postoperative complication rate was 7.06％ (6/85) in the FTS group and 20.00％ (17/85) in the CPM group (all P ＜0.05).In FTS group,the first flatus time was (59.01 ±2.73) h,the first defecation time was (3.35 ± 1.37) d,removing time of chest tube was (2.76 ±0.34) d,and postoperative hospital days was (8.16 ± 0.80) d; in the control group,they were (90.16 ±2.82) h,(4.78 ± 1.74) d,(4.39 ±0.25) d,and (10.93 ± 1.39) d respectively,showing significant differences (all P ＜0.05).The operative time was similar between these two groups.Conclusion The new concept of FTS by nutrition risk screening and intervention apparently can accelerate recovery after esophagngastrectomy,reduce the rate of overall complications,promote bowel function recovery,and decrease morbidity in the perioperative period for patients with esophageal carcinoma.

Objectives: To observe the drug seeking behavior in chronically morphine pretreated, abstinent rats and determine brain regions involved in this behavior. Methods: Preferences for morphine associated environments and Fos expression in some brain regions were measured 35 days after withdrawal of chronic morphine treatment. Results: The preference for the morphine environment was greatly increased by morphine pretreatment. The conditioned morphine pretreated group showed significantly higher Fos levels than either the conditioned or non conditioned control groups in the Cg, Ac C, BNST VL, ACE and ABL. Conclusions: A relationship between place preference behavior and neural indices of activation exist in the forebrain in response to morphine conditioned cues, which may be chronically modulated by prior morphine exposure.

BACKGROUND:There is no effective therapy for obliterative bronchiolitis after tracheal transplantation. A therapeutic strategy at microRNA (miRNA) molecular level plays a crucial role in the prevention and treatment of complications after organ transplantation.
OBJECTIVE:To analyze the miRNA differential expression profile in response to obliterative bronchiolitis after orthotopic tracheal transplantation in rats.
METHODS:The obliterative bronchiolitis model after lung transplantation was established through orthotopic tracheal transplantation in inbred strains of rats, and then was identified using histoIogical examination. Total miRNAs were detected by miRNA array and significantly differential expressed miRNAs were filtrated in the transplanted trachea tissues. The miRNA-146a, miRNA-155 and miRNA-451 with significantly differential expressions were used for relative quantitative study. Quantitative real-time reverse transcription-polymerase chain reaction was applied to verify the reliability of miRNA array results.
RESULTS AND CONCLUSION:The pathological examination showed that, obliterative bronchiolitis model in rats was successful y established at 4 weeks after orthotopic tracheal transplantation. A total of obliterative bronchiolitis-related 29 miRNAs were found in miRNA expression profiles, including 14 miRNAs with significantly down-regulated expression and 15 miRNAs with significantly up-regulated expression. Among them, the significantly up-regulated miRNAs (miRNA-146a and miRNA-155) and the significantly down-regulated miRNA-451 were involved in immuno-inflammatory reaction. The miRNAs play an important role in regulating pathophysiological changes of obliterative bronchiolitis after lung transplantation.

Objective In a prospective randomized controlled pilot study, effects of postoperative pulmonary complications on a conservative treatment surgery (CTS) and fast track surgery (FTS) treatment regimen in non-small cell lung cancer (NSCLC) patients undergoing pulmonary lobectomy were compared.Methods Eighty patients who underwent radical pulmonary lobectomy surgical treatment for non-small cell lung cancer disease from January 2008 to May 2010 in our hospital were random assigned to either fast track surgery treatment (40 FTS group) or conservative treatment surgery regimen (40 CTS group). Study endpoints were pulmonary complications ( pneumonia, atelectasis, prolonged air leak ＞ 7 days); Further parameters assessed in the postoperative course of patients were the need for postoperative mechanical ventilation, temperature at the end of the operation, length of stay (LOS) on intensive care unit (ICU) and day of discharge. Results The rate of postoperative pulmonary complications was 34. 21% in CTS group and 8. 33% in FTS group ( P ＜0. 05). Median length of stay on ICU was comparable in both groups ( 1 day),but the day of discharge was significantly different in both groups [( 11. 1 ±3.6)d vs ( 16. 6 ±5.7)d, P ＜0. 01]. Conclusion Using this fast track clinical pathway, the rate of pulmonary complications could be significantly decreased as compared to a conservative treatment regimen. Our results supported the implementation of an optimized perioperative treatment in lung surgery for non-small cell lung cancer patients undergoing radical pulmonary in order to reduce pulmonary complications after major lung surgery.

Objective To analyze the influencing factors of mechanical phlebitis(MP)during peripherally inserted central catheterization(PICC)in very/extremely low birth weight infants(VLBWI/ELBWI)in neonatal Intensive Care Unit(NICU).Methods The clinical data of VLBWI/ELBWI who underwent PICC catheterization were retrospectively analyzed.Multivariate Logistic regression model was used to analyze the influencing factors of MP.Results The incidence of MP after implementa-tion of PICC in VLBWI/ELBWI was 26.1％(116/444).Univariate analysis showed that the position of catheter tip,catheter vein,gestational age,body mass at birth,gestational age when cathetering,body mass when cathetering,puncture times and length were influencing factors for MP in VLBWI/ELBWI(P＜0.05).Multivariate Logistic regression analysis showed that abnormal position ofcathe-ter tip(OR=2.526;95％CI,1.532 to 4.164)and puncture times ≥ 2 times(OR=1.952;95％CI,1.017 to 3.747)were independent risk factors.Conclusion The abnormal catheter tip position and the number of puncturing ≥2 times increase the risk of mechanical phlebitis in VLBWI/ELBWI after PICC.Early intervention should be taken as soon as possible to avoid the occurrence of MP so as to relieve infants'pain and improve the quality of clinical care.

Objective To analyze the influencing factors of mechanical phlebitis(MP)during peripherally inserted central catheterization(PICC)in very/extremely low birth weight infants(VLBWI/ELBWI)in neonatal Intensive Care Unit(NICU).Methods The clinical data of VLBWI/ELBWI who underwent PICC catheterization were retrospectively analyzed.Multivariate Logistic regression model was used to analyze the influencing factors of MP.Results The incidence of MP after implementa-tion of PICC in VLBWI/ELBWI was 26.1％(116/444).Univariate analysis showed that the position of catheter tip,catheter vein,gestational age,body mass at birth,gestational age when cathetering,body mass when cathetering,puncture times and length were influencing factors for MP in VLBWI/ELBWI(P＜0.05).Multivariate Logistic regression analysis showed that abnormal position ofcathe-ter tip(OR=2.526;95％CI,1.532 to 4.164)and puncture times ≥ 2 times(OR=1.952;95％CI,1.017 to 3.747)were independent risk factors.Conclusion The abnormal catheter tip position and the number of puncturing ≥2 times increase the risk of mechanical phlebitis in VLBWI/ELBWI after PICC.Early intervention should be taken as soon as possible to avoid the occurrence of MP so as to relieve infants'pain and improve the quality of clinical care.

Objective:To investigate the expression levels of serum KLK5, IL-17 and IL-18 in patients with rosacea and their clinical significance.Methods:A prospective study included 65 patients with rosacea from the Department of Dermatology, Sichuan Provincial People＇s Hospital, from May to October 2022. There were 8 males and 57 females with an average age of (30.9±9.8) years, including 47 cases of erythematotelangiectatic type and 18 cases of papulopustular type. Twenty healthy individuals from the same hospital＇s physical examination during the same period were included as control group, consisting of 3 males and 17 females with an average age of (33.8±10.0) years. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of serum KLK5, IL-17, and IL-18. Investigator＇s global assessment (IGA) score was used to assess the severity of papules and pustules, and clinical erythema assessment (CEA) score was used to assess the severity of persistent erythema. The expression levels of serum KLK5, IL-17, and IL-18 were compared between the two groups, and the correlation between the severity of the disease and the expression levels of KLK5, IL-17, and IL-18 was analyzed. Additionally, the expression levels of KLK5, IL-17, and IL-18 in different subtypes of rosacea were compared.Results:The expression levels of serum KLK5, IL-17, and IL-18 in the rosacea group were (3134.01±448.82), (154.78±37.64), (236.24±38.81) pg/ml, respectively, all of which were higher than those in the healthy control group (2421.54±340.07), (95.36±24.94), (181.61±23.88) pg/ml, with statistically significant differences (all P<0.05). The levels of serum KLK5, IL-17, and IL-18 in patients with rosacea were positively correlated with IGA scores ( r=0.534, 0.767, 0.417) and CEA scores ( r=0.852, 0.459, 0.309) (all P<0.05). There were no statistically significant differences in the expression levels of serum KLK5, IL-17, and IL-18 between the erythematotelangiectatic and papulopustular subtypes of rosacea (all P>0.05). Conclusions:The expression levels of serum KLK5, IL-17 and IL-18 in patients with rosacea are higher than those in the healthy control group and are positively correlated with the severity of rosacea.

Objective:To explore the factors influencing complete remission in patients with diffuse large B-cell lymphoma (DLBCL), and to explore the effect of the interaction of Karnofsky performance status scale (KPS) scores and the level of lactate dehydrogenases (LDH) on whether patients with DLBCL are completely relieved.Methods:The clinical data of 373 DLBCL patients admitted to Shanxi Province Cancer Hospital from January 2014 to December 2020 were retrospectively analyzed. SPSS 25.0 logistic regression model and Cox proportional risk regression models were used to explore the factors affecting complete remission in patients with DLBCL and to explore whether there was a multiplicative interaction between the factors. For factors with multiplicative interactions, the Matrix package, epiR package, and survival package in R 4.2.0 software were used to analyze whether there was an additive interaction. The relative excess risk of interaction (RERI), attributable proportion due to interaction (AP), and the synergy index (S) were used to evaluate the presence of additive interactions.Results:Elevated β 2 macroglobulin (β 2-MG), KPS scores below 80, and elevated LDH were risk factors for incomplete remission in patients with DLBCL (all P < 0.05). The risk of incomplete remission in patients with elevated β 2-MG, KPS scores below 80 and LDH was 1.971 times ( OR = 1.971, 95% CI 1.161-3.346), 2.056 times ( OR = 2.056, 95% CI 1.057-4.000) and 3.351 times ( OR = 3.351, 95% CI 1.783-6.300) higher than those in patients with normal β 2-MG, KPS scores above 80 and non-elevated LDH, respectively. There was a negative multiplicative interaction between the two risk factors of KPS scores below 80 and elevated LDH ( OR = 0.317, 95% CI 0.126-0.785). The estimated value of RERI, AP and S was -2.07 (95% CI -4.79-0.64),0.50 (95% CI -1.68-0.32),0.50 (95% CI 0.22-1.13), respectively; and there was no additive interaction among them. Conclusions:Elevated β 2-MG, KPS scores below 80, and elevated LDH are risk factors influencing incomplete remission for patients with DLBCL. The combined effect in patients with the combination of elevated LDH and KPS scores below 80 is lower than the single effect of the multiple of the both. There is a negative multiplicative interaction and no additive interaction in DLBCL patients with KPS scores below 80 and elevated LDH level.

Objective:In this study, we aimed to compare the short-term safety of two digestive tract reconstruction techniques, laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis, following radical resection of Siewert Type II adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, we analyzed relevant clinical data of 139 patients who had undergone radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. These included 89 patients treated at the First Affiliated Hospital of Air Force Medical University from November 2021 to July 2023, 36 patients treated at the First Affiliated Hospital of Xi'an Jiaotong University from December 2020 to June 2021, and 14 patients treated at the Yuncheng Central Hospital in Shanxi Province from September 2021 to November 2022. The group consisted of 107 men (77.0%) and 32 women (23.0%) of mean age 62.5±9.3 years. Forty-eight patients underwent laparoscopic total abdominal overlap anastomosis (overlap group), and 91 laparoscopic-assisted end-to-side anastomosis (end-to-side group). Clinical data, surgical information, pathological findings, postoperative recovery, and related complications were compared between the two groups.Results:There were no significant differences in general clinical data between the overlap and end-to-side anastomosis groups (all P>0.05), indicating comparability. There was no significant difference in operation time (267.2±60.1 minutes vs. 262.8±70.6 minutes, t=0.370, P=0.712). However, the intraoperative blood loss in the overlap group (100 [50, 100] mL) was significantly lower compared to the end-to-side group (100[50, 175] mL, Z=2.776, P=0.005). Compared to the end-to-side group, longer distances between the tumor and distal resection margin proximal(1.7±1.0 cm vs. 1.3±0.9 cm, t=2.487, P=0.014) and the tumor and distal resection margin (9.5±2.9 cm vs. 7.9±3.5 cm, t=2.667, P=0.009) were achieved in the overlap group. Compared with the end-to-side group, the overlap group achieved significantly earlier postoperative ambulation (1.0 [1.0, 2.0] days vs. 2.0 [1.0, 3.0] days, Z=3.117, P=0.002), earlier time to first drink (4.7±2.6 days vs. 6.2±3.0 days, t=2.851, P=0.005), and earlier time to first meal (6.0±2.7 days vs. 7.1±3.0 days, t=2.170, P=0.032). However, the hospitalization costs were higher in the overlap group (113, 105.5±37, 766.3) yuan vs. (97, 250.2±27, 746.9) yuan; this difference is significant ( t=2.818, P=0.006). There were no significant differences between the two groups in postoperative hospital stay, total number of lymph nodes cleared, or time to first postoperative flatus (all P>0.05). The incidence of surgery-related complications was 22.9%(11/48) in the overlap group and 19.8% (18/91) in the end-to-side group; this difference is not significant (χ2=0.187, P=0.831). Further comparison of complications using the Clavien-Dindo classification also showed no significant differences ( Z=0.406, P=0.685). Conclusions:Both laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis are feasible for radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. Laparoscopic total abdominal overlap anastomosis achieves longer proximal and distal resection margins and better postoperative recovery; however, end-to-side anastomosis is more cost-effective.