Objective To investigate the influence of fast track surgery (FTS) on insulin resistance indexes and inflammatory reaction in colorectal cancer patients who received laparoscopic surgery.Methods A total of 62 patients were randomly divided into control group (n=31) or FTS group (n=31).The postoperative first flatus and defecation time, postoperative hospital stay, hospitalization expenditure, and postoperative complications were recorded.Insulin resistance indexes and inflammatory reaction were measured before operation (T0) as well as on the 1st, 3rd, and 7th postoperative days (T1, T3, and T7), including fasting blood-glucose (FBG), fasting insulin (FINS), serum level of interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor (TNF-α).The insulin resistance index (HOMA-IR) was calculated at the same time points.Results The postoperative time of flatus and defecation in the FTS group was significantly shorter than that in the control group (t=3.088, P=0.003;t=4.227, P=0.000), the postoperative hospital stay and total hospitalization expenditure were significantly lower in FTS group (t=3.937, P=0.000;t=3.478, P=0.003).No significant difference was found in the complication rate between the two groups (χ2=0.267,P=0.605).The inflammatory indexes and insulin resistance indexes in the two groups at T1 and T3 time points were higher than those at T0 time points (P<0.05).Compared to the FTS group at T1 and T3 time points, the levels of IL-6, CRP, TNF-α, FINS, and HOMA-IR in the control group increased more obviously (P<0.05), but the elevation blood FBG was not obvious (T1: t=0.870, P=0.388;T3: t=0.870, P=0.388).There were no significant differences in IL-6 and TNF-α in the two groups between the T7 and T0 time points (P>0.05), but the levels of CRP, FBG, FINS, and HOMA-IR at T7 time points were significantly higher than those at the T0 time points in the two groups (P<0.05).The levels of IL-6, TNF-α, FBG, FINS, and HOMA-IR at T7 had no significant differences between the two groups (P>0.05), but the level of CRP in the control group was significantly higher than that in the FTS group (t=-4.527, P=0.000).Conclusion FTS may promote the early recovery of gastrointestinal functions, reduce stress reactions and postoperative insulin levels, thus being conducive to fast rehabilitation in colorectal cancer patients with laparoscopic surgery.

ObjectiveTo explore the efficacy of several skin flaps in treating of the soft tissue defect with or without osteomyelitis at foot in cold environment. MethodsThe damaged foot should be re-warmed immediately. Several kinds of skin flaps were transplanted for 35 cases of soft tissue defect at foot in particularly, among them, 11 cases were with osteomyelitis and bone exposuring. ResultsThere were 31 cases survived by the first intention, 4 case presented partial necroses and healing by dress changing at the second intention. The appearance and function of damaged feet recovered well.ConclusionImmediate re-warming and skin flaps transplant can repair the acute or old soft tissue defect with osteomyelitis in cold environment.

Objective To explore the correlation between hyponatremia at admission and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Methods The 331 cases of elderly patients with intestinal obstruction(aged ≥ 60 years)who visited the General Surgery Department of Nanjing Meishan Hospital from January 2017 to December 2020 were selected as the research objects for retrospective cohort study analysis.According to the patient's blood sodium level at admission,they are divided into two groups:the hyponatremia group(Na＜135 mmol/L)and the non hyponatremia group(Na≥135 mmol/L).Divided into death group and survival group based on whether death occurred within one year after discharge.SPSS 25.0 software was used for statistical analysis.Independent sample t test,x2 test,Kaplan Meier method,and multivariate Cox regression analysis were used to observe the correlation between admission hyponatremia and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Results A total of 331 patients were enrolled.The incidence of hyponatremia was 32.3％,and 56 deaths occurred within one year,accounting for 16.92％.The one-year mortality rate in the hyponatremia group was 23.4％(25/107),which was higher than 13.8％(31/224)in the non hyponatremia group.The difference was statistically significant(P＜0.05).The survival analysis(Kaplan Meier)results showed that the survival rate of the hyponatremia group was lower than that of the non hyponatremia group(Log Rank P＜0.05).After adjusting for other confounding factors in multivariate Cox regression analysis,hyponatremia(HR=1.88,95％CI:1.07-3.29)was an independent risk factor for one-year all-cause mortality in elderly patients with intestinal obstruction(P＜0.05).Conclusion Hyponatremia at admission is an independent risk factor for all cause mortality in elderly patients with intestinal obstruction within one year after discharge.

Cashmere, also known as soft gold, is produced from the secondary hair follicles (SHFs) of cashmere goats. The number of SHFs determines the yield and quality of cashmere; therefore, it is of interest to investigate the transcriptional profiles present during cashmere goat hair follicle development. However, mechanisms underlying this development process remain largely unexplored, and studies regarding hair follicle development mostly use a murine research model. In this study, to provide a comprehensive understanding of cellular heterogeneity and cell fate decisions, single-cell RNA sequencing was performed on 19,705 single cells of the dorsal skin from cashmere goat fetuses at induction (embryonic day 60; E60), organogenesis (E90), and cytodifferentiation (E120) stages. For the first time, unsupervised clustering analysis identified 16 cell clusters, and their corresponding cell types were also characterized. Based on lineage inference, a detailed molecular landscape was revealed along the dermal and epidermal cell lineage developmental pathways. Notably, our current data also confirmed the heterogeneity of dermal papillae from different hair follicle types, which was further validated by immunofluorescence analysis. The current study identifies different biomarkers during cashmere goat hair follicle development and has implications for cashmere goat breeding in the future.

The morbidity and mortality of myeloproliferative neoplasms (MPNs) are primarily caused by arterial and venous complications, progression to myelofibrosis, and transformation to acute leukemia. However, identifying molecular-based biomarkers for risk stratification of patients with MPNs remains a challenge. We have previously shown that interferon regulatory factor-8 (IRF8) and IRF4 serve as tumor suppressors in myeloid cells. In this study, we evaluated the expression of IRF4 and IRF8 and the JAK2V617F mutant allele burden in patients with MPNs. Patients with decreased IRF4 expression were correlated with a more developed MPN phenotype in myelofibrosis (MF) and secondary AML (sAML) transformed from MPNs versus essential thrombocythemia (ET). Negative correlations between the JAK2V617F allele burden and the expression of IRF8 (P < 0.05) and IRF4 (P < 0.001) and between white blood cell (WBC) count and IRF4 expression (P < 0.05) were found in ET patients. IRF8 expression was negatively correlated with the JAK2V617F allele burden (P < 0.05) in polycythemia vera patients. Complete response (CR), partial response (PR), and no response (NR) were observed in 67.5%,10%, and 22.5% of ET patients treated with hydroxyurea (HU), respectively, in 12 months. At 3 months, patients in the CR group showed high IRF4 and IRF8 expression compared with patients in the PR and NR groups. In the 12-month therapy period, low IRF4 and IRF8 expression were independently associated with the unfavorable response to HU and high WBC count. Our data indicate that the expression of IRF4 and IRF8 was associated with the MPN phenotype, which may serve as biomarkers for the response to HU in ET.
Biomarkers ; Humans ; Hydroxyurea/therapeutic use* ; Interferon Regulatory Factors/genetics* ; Janus Kinase 2/genetics* ; Leukemia, Myeloid, Acute/genetics* ; Mutation ; Phenotype ; Primary Myelofibrosis/genetics* ; Thrombocythemia, Essential/genetics*