Objective:To explore the differences in bacterial community structure between proximal colon cancer (PC), distal colon cancer (DC), and rectal cancer (RC), and the values of featured microbiota in differentiating PC with tumor markers.Methods:This case-control study enrolled 85 newly diagnosed colorectal cancer patients, including 22 PC, 15 DC and 48 RC patients, and 8 colorectal adenoma patients from May 2019 to July 2022 at the Department of General Surgery, Anyang Oncology Hospital. The blood and fecal samples were collected before surgery and then subjected to biochemical tests for tumor markers and 16S rDNA tests, respectively. SPSS (27.0.1) was applied to perform the t-test, one-way ANOVA, Mann-Whitney U test, Kruskal-Wallis H test, and Chi-Squared Test. Also, the receiver operating characteristic curve (ROC) was plotted on tumor markers and/or f_Bacteroidaceae with SPSS software .Results:All groups had significant differences in the CA125 ( F=3.543, P<0.05), CA72-4 ( F=3.596, P<0.05), and serum tumor-associated materials (TAM) levels ( F=5.787, P<0.01). In PC group, the levels of CA125 [PC vs RC, (36.84±6.30) kU/L vs (12.73±4.21) kU/L, P<0.01] and CA72-4 [PC vs RC, (45.56±10.86) kU/L vs (3.30±7.63) kU/L, P<0.01] were significantly higher than that of the RC group, while the level of TAM was remarkably elevated in PC group than in RC group [PC vs RC, (124.84±5.19) U/ml vs (102.44±3.63) U/ml, P<0.001] and CRA group [PC vs CRA, (124.84±5.19) U/ml vs (95.39±8.42) U/ml, P<0.01]. The LEfSe analysis showed that the featured microbiota in the PC group included f_Bacteroidaceae, f_Neisseriaceae, f_Clostridiaceae_1, f_Spirochaetaceae, and so on. The largest area under the ROC belonged to the combination of TAM and f_Bacteroidaceae, which reached 0.845 (95% CI 0.747-0.944), with sensitivity being 0.857 and specificity being 0.815. Conclusions:There is heterogeneity in gut microbiota composition among PC, DC, RC, and CRA. The combination of gut microbiota and tumor biomarkers demonstrated good differentiating effects in proximal colon cancers.

The development of minimally invasive robotic surgery has always been the focus of the discipline. Pancreaticoduodenectomy has been regarded as the "Mount Everest" of surgical operations because of its high risk and mounting difficulty. Standardized surgical steps and easy-to-follow operation techniques are helpful to promote the application of robotic pancreaticoduodenectomy (RPD). Therefore, in this paper, we summarize the RPD to form an 18-step surgery procedure and analyze the key points of circumferential vessel resection and reconstructive anastomosis techniques, based on the experience of RPD at the First Medical Center of Chinese People's Liberation Army General Hospital, with the hope of promoting the in-depth application of robotics in pancreatic surgery and furthering the establishment of RPD application standards.

Objective To investigate the role of sodium-glucose cotransporter 1(SGLT1)inhibitor mizagliflozin(MIZA)in autosomal dominant polycystic kidney disease(ADPKD).Methods Western blotting,quantitative polymerase chain reaction(qPCR),and immunofluorescence staining were used to determine the expression and distribution of SGLT1 in kidney tissues of PKD1-/-and PKD1+/+mice,human renal cancer adjacent tissue and ADPKD tissue.Renal cyst lining epithelial cells OX161 and renal tubular epithelial cells UCL93 were treated with MIZA,incubated at 37℃for 24,48,and 72 h,and then were subjected to methyl thiazolyl tetrazolium and colony formation assay to observe cell proliferation.The qPCR method was used to determine the mRNA levels of collagen 1α1,collagen 3α1,and fibronectin 1 in OX161 cells treated with 100 μmol/L MIZA for 48 h.The Madin-Darby canine kidney(MDCK)cell 3D cyst formation assay verified the effect of MIZA on cyst formation.The mRNA-seq technology was used to detect differentially expressed genes between UCL93 cells and OX161 cells,and between OX161 cells and OX161 cells treated with 100 μmol/L MIZA for 48 h,and then the differentially expressed genes were analyzed with Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis.Results The expression level of SGLT1 was significantly increased in the tissues of ADPKD patients and PKD1-/-mice compared to those in normal kidney tissues(P＜0.05,P＜0.01).Immunofluorescence staining revealed that SGLT1 was mainly expressed in the cystic lining epithelial cells.Additionally,MIZA inhibited the proliferation and fibrosis of polycystic kidney cells in a concentration-and time-dependent manner,and also inhibited cyst formation in 3D formation assay in vitro.The mRNA-seq analysis and KEGG enrichment analysis showed that differentially expressed genes between OX161 cells and OX161 cells cultured in 100 μmol/L MIZA for 48 h were mainly enriched in the phosphatidylinositol 3-kinase(PI3K)-protein kinase B(Akt)and mitogen-activated protein kinase(MAPK)signaling pathways,which were the same as those between OX161 cells and UCL93 cells.Conclusion The SGLT1 inhibitor MIZA may inhibit the proliferation and fibrosis of polycystic kidney cells through signaling pathways such as PI3K-Akt and MAPK,delaying the growth of polycystic kidney,and it is a potential therapeutic target for ADPKD.

Objective:To investigate the effect of prenatal dexamethasone on short-term outcomes and long-term neurological development in late preterm infants with twin pregnancy.Methods:A total of 315 pregnant women with twin pregnancy and their preterm infants who delivered in Peking University Third Hospital from January 2019 to December 2022 were retrospectively analyzed. The clinical data of pregnant women and preterm infants were collected. They were divided into non-medication group (93 pregnant women and 186 preterm infants), medication after 34 weeks group (123 pregnant women and 246 preterm infants), and medication before 34 weeks group (99 pregnant women and 198 preterm infants). Short-term outcomes of preterm infants were analyzed, including the incidence of neonatal respiratory distress syndrome (NRDS), wet lung, hypoglycemia, neonatal septicemia, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD) and neonatal necrotizing enterocolitis (NEC). "Ages and Stages Questionnaire-Third Edition (ASQ-3) scale" was used to follow up the late neurological development of preterm infants at the corrected age of 6-54 months, and the level of neurological development was compared.Results:(1) General conditions: the gestational age at delivery in the non-medication group [36.1 weeks (35.6, 36.6 weeks)] was later than that in the medication after 34 weeks group [36.1 weeks (35.2, 36.4 weeks)] and medication before 34 weeks group [35.2 weeks (34.2, 36.2 weeks)] groups, and the differences were statistically significant (all P<0.05). After correcting for gestational age, there was no significant difference in birth weight among the three groups ( H=3.808, P=0.149). There were no significant differences in gender and the proportion of small for gestational age among the three groups (all P>0.05). (2) Short-term outcome: the incidence of wet lung was 7.0% (13/186), 11.0% (27/246) and 16.2% (32/198) in the non-medication group, medication after 34 weeks group and medication before 34 weeks group, respectively, and the difference was statistically significant ( P=0.018). There were no significant differences in the incidence rates of NRDS, hypoglycemia, sepsis, IVH, BPD, and NEC among the three groups (all P>0.05). Logistic regression analysis with gestational age and newborn birth weight as confounding factors showed that early gestational age ( OR=0.884, 95% CI: 0.837-0.933, P<0.001) and increased incidence of selective intrauterine growth restriction type I ( OR=2.967, 95% CI: 1.153-7.639, P=0.024) could both lead to an increased incidence of wet lung. (3) Long-term outcomes: a total of 109 pregnant women completed the follow-up, and 218 preterm infants with a corrected age of 6-54 months at the end of follow-up were enrolled, including 86 cases in the non-medication group, 66 cases in the medication after 34 weeks group, and 66 cases in the medication before 34 weeks group. There were no significant differences in the scores of communication, gross motor, fine motor, problem solving and personal-social among the three groups (all P>0.05). Conclusion:Prenatal administration of a single course of dexamethasone does not affect the neonatal birth weight and short-term outcomes of twin late preterm infants, and has no adverse effect on the neurological development of twin late preterm infants with a corrected age of 6-54 months.

Objective To investigate the effect and mechanism of Qianggu Tongbi capsule on osteoarthritis factors in rats.Methods Osteoarthritis(OA)rat model was established by anterior cruciate ligament transection method.Rats were ran-domly divided into model group,Qianggu Tongbi capsule group and glucosamine group.HE staining was used to identify the model.Toluidine blue staining was used to observe the changes of cartilage.Real-time quantitative polymerase chain reaction(qRT-PCR)was applied to detect the expression of Toll-like receptors(TLR4)and nuclear factor kappa-B(NF-κB)in each group.The levels of IL-1β,TNF-α,and IL-6 were measured by the enzyme linked immunosorbent assay(ELISA)kit.The levels of TLR4 and p-NF-κB were detected by immunohistochemistry.Results HE staining showed that,compared with the control group,a large number of inflammatory cell infiltration and synovial tissue thickening were observed in the model group,while the inflammatory cell infiltration and synovial tissue thickening were not obvious in the Qianggu Tongbi capsule and glu-cosamine groups.Toluidine blue staining results showed that chondroitin sulfate in the cartilage tissue of the model group was significantly reduced compared with the control group,while levels of chondroitin sulfate in the Qianggu Tongbi capsule group and glucosamine group were significantly increased.Compared with control group,the expression and immunohistochemical re-sults of TLR4 and NF-κB,and the levels of IL-1β,TNF-α and IL-6 in model group were significantly increased(all P＜0.05).Compared with model group,the expression and immunohistochemical results of TLR4 and NF-KB,and the levels of IL-1β,TNF-α and IL-6 in Qianggu Tongbi capsule group and glucosamine group were significantly decreased(all P＜0.05).Conclusion Qianggu Tongbi capsule can inhibit expression of TLR4 and NF-κB by reducing the production of inflammatory factors to a-chieve the effect of treatmenting osteoarthritis.

OBJECTIVE: To retrospectively analyze the clinical characteristics and prognostic factors of patients with primary cutaneous lymphoma. METHODS: The clinical data of 22 patients with primary cutaneous lymphoma admitted to Xinjiang Hotan District People's Hospital, Heji Hospital affiliated to Changzhi Medical College and the Fifth Medical Center of PLA General Hospital from January 2013 to June 2021 were retrospectively analyzed. RESULTS: The incidence of primary cutaneous T cell and NK/T cell lymphoma was about 91.9/100 000, and the incidence of primary cutaneous B cell lymphoma was about 14.5/100 000. The overall survival (OS) of patients aged ≥65 years was significantly shorter than that of patients younger than 65 years (P <0.05). Patients with elevated β₂-microglobulin (β₂-MG) had shorter OS and progression-free survival (PFS) (both P <0.05). Patients who achieved complete/partial response after initial treatment had longer OS than those with stable or progressive disease (P <0.05). There were significant differences in OS and PFS among patients with different pathological types of primary cutaneous lymphoma that originated from T and NK/T cells, the OS and PFS of patients with mycosis fungoides were longer than those of patients with other pathological types (both P <0.05). In addition, disease stage might also affect the PFS of the patients (P =0.056). CONCLUSION The age, disease stage, β₂-MG level, pathological type and remission state after treatment of the patients were related to the clinical prognosis.
Humans ; Prognosis ; Retrospective Studies ; Remission Induction ; Lymphoma

OBJECTIVE: To investigate the effect of acute myeloid leukemia cells in leukemia-microenvironment on proliferation and apoptosis of bone marrow-derived mesenchymal stromal cells (BM-MSC). METHODS: Acute myeloid leukemia (AML) murine models overexpressing MLL-AF9 were established. The number of BM-MSC of wild type (WT) and AML-derived mice were analyzed by flow cytometry. Morphology and growth differences between WT and AML-derived BM-MSC were analyzed by inverted fluorescence microscope. Proliferation and apoptosis of BM-MSC between these two groups were detected by Brdu and Annexin V/PI. RESULTS: Compared with WT-derived BM-MSC, the number and proliferation rate of AML-derived BM-MSC significantly increased (P<0.01, P<0.001), while apoptosis rate decreased (P<0.05). When cultured in vitro, BM-MSC grew faster under conditional medium. CONCLUSION AML cells can promote proliferation and inhibit apoptosis of BM-MSC.
Animals ; Apoptosis ; Bone Marrow ; Bone Marrow Cells ; Cell Proliferation ; Humans ; Leukemia, Myeloid, Acute ; Mesenchymal Stem Cells ; Mice ; Tumor Microenvironment

Tertiary lymphoid structure (TLS) is the ectopic lymphoid tissue around the chronic inflammatory site of tumor, infection diseases, autoimmunity diseases, organ transplantation and so on. TLS is regarded as the vital niche of antitumor immune response in tumor microenvironment for abundant immune cells, and is correlated with better clinical outcomes and immunotherapy response in most solid tumors. As a typical inflammation-driven cancer, hepatocellular carcinoma (HCC) is controversial with the influence of TLS on patients prognosis. In this paper, the composition, formation mechanism, recognition and clinical value of TLS in HCC were briefly reviewed.

Objective To explore the effect of books and toys on early childhood development in poor rural areas of China.Methods The baseline survey data of the Integrated Early Childhood Development (IECD) conducted in 2013,which was supported by the United Nations International Children's Emergency Fund (UNICEF) China Office,were analyzed retrospectively in this study.The survey was conducted in 6 counties in 2 provinces of China (Shanxi and Guizhou),and all 6 neighboring counties were located in extremely poor areas.The socio-demographic characteristics and caring behaviors of the caregivers (the lack of children's books and toys) were assessed by UNICEF's Multiple Indicator Cluster Surveys-5 and caregivers' depression was assessed by the Zung Self-rating Depression Scale.A total of 2701 children were enrolled,of these,1151(42.62％) were girls,the age (18± 10) months and 1 263 (46.76％)children were from Shanxi Province,the remaining 1 438 (53.24％) children were from Guizhou Province.The early childhood developmental status was evaluated by Ages and Stages Questionnaires (ASQ).Log-binomial model was used to analyze the association between early childhood development and the lack of children's books and toys.Furthermore,sensitivity analyses (data stratification) were made to explore the effect of books and toys on early childhood development under different caregiving conditions with different caregivers who were depressive or non-depressive.Results Among the 2 701 participants,1 537 (56.90％) children lacked of books,1 148 (42.50％) children lacked of toys,the suspected development delay (SDD) prevalences of overall ASQ,communication (CM),gross motor (GM),fine motor (FM),cognitivity (CG) and personal-social (PS) domains were 33.02％ (892/2 701),15.51％ (419/2 701),13.25％ (358/2 701),15.66％(423/2 701),14.96％ (404/2 701) and 11.81％ (319/2 701).Under adjustment of the potential confounders,the Log-binomial regression showed that children who lacked books had significantly higher risk of SDD in overall ASQ (prevalence ratio (PR)=1.27,95％CI:1.11-1.45) and CM (PR=1.64,95％CI:1.31-2.07) than those who had sufficient books.Compared with children who had sufficient toys,those who lacked the toys also had the increased risk of SDD in overall ASQ (PR=1.34,95％CI:1.19-1.50),CM (PR=1.44,95％CI:1.18-1.76),GM (PR=1.54,95％CI:1.24-1.91),FM (PR=1.86,95％CI:1.52-2.27),CG (PR=1.80,95％CI:1.47-2.20) and PS (PR=1.88,95％CI:1.49-2.39).Sensitivity analysis revealed that the lack of books increased the risk of SDD in overall ASQ of the caregivers' non-depression group (PR=1.35,95％CI:1.08-1.71) and depression group (PR=1.17,95％CI:1.01-1.38),and the lack of toys increased the risk of SDD in overall ASQ of the caregivers' depression group (PR=1.54,95％CI:1.32-1.79).Conclusion Lack of childrens' books and shortage of toys were independent risk factors for early childhood development in poor rural areas of China and both of them increased the risk of SDD significantly.

Objective To explore the clinical efficacy of secondary posterior internal fixation after transoral anterior atlantoaxial release under 3D operative microscopy for treatment of irreducible atlantoaxial dislocation.Methods From January 2014 to May 2016,12 patients with irreducible atlantoaxial dislocation were treated with secondary posterior internal fixation after transoral anterior atlantoaxial release under 3D operative microscopy in our hospital.They were 7 males and 5 females,with an average age of 37.1 years (from 25 to 54 years).The efficacy was analyzed in terms of their visual analogue scale (VAS),Japanese Orthopaedic Association (JOA) scoring,improvement rate of neurological function,American Spinal Injury Association (ASIA) grading,atlas-dens interval (ADI),space available for the cord (SAC) and cervicomedullary angle (CMA) before and one year after operation.Results The patients were followed up for more than one year.All the atlantoaxial joints obtained anatomic reduction.Their preoperative values of VAS (5.73 ± 1.36 points),JOA score (9.03 ± 2.12 points),ADI (8.34 ± 1.12 mm),SAC (9.53 ± 0.69 mm) and CMA (121.23°±4.32°) were significantly improved one year after operation (1.21 ±0.63 points,14.32±2.51 points,2.83 ± 0.36 mm,14.23 ± 1.22 mm and 153.53° ± 9.25°, respectively) (P ＜0.05).The improvement rate of neurological function increased gradually with the postoperative time,reaching 94.14％ ±5.11％ one year after operation.The postoperative ASIA grading was significantly improved too one year after operation (P ＜ 0.05).Conclusion Secondary posterior internal fixation after transoral anterior atlantoaxial release under 3D operative microscopy may lead to fine clinical efficacy one year after operation for patients with irreducible atlantoaxial dislocation.