Objective To explore the clinical effect of creatine phosphate on infantile with rotaviral enteritis and myocardial damage.Methods One hundred and twenty children with rotaviral enteritis and myocardial damage were randomly divided into the control group (n =60) and observation group (n =60).Two groups were given antiviral,rehydration,nutritional support,redressing acid-base imbalance and electrolyte disorders and other conventional treatment.The patients of the control group were given 160 mg/(kg · d) 1,6Fructose Diphosphate(1 times/d) on the basis of routine treatment,while those in the observation group were given 1.0 g creatine phosphate + 150 ml 5％ glucose injection(1 times/d) on the basis of routine treatment,both courses of two groups were 7 days.The levels of myocardial enzymes were measured and the clinical effect and adverse reactions were recorded.Results The total effective rate in observation group was 95.0％ (57/60),obviously higher than that of control group (80.0％ (48/60)) and the differences were statistically significant (x2 =6.268,P ＜ 0.05).There were no statistical significant difference in terms of myocardial enzyme between the two groups before treatment(P ＞0.05).The level of lactate dehydmgenase(LDH),creatine kinase (CK),creatine kinase isoenzyme (CK-MB) and aspartate aminotransferase (AST) of observation group were (163.8 ±18.5) U/L,(152.8±26.4) U/L,(19.4±7.8) U/Land (24.4 ±6.8) U/Lafter treatment,and (193.4 ± 22.8) U/L,(168.6 ± 32.6) U/L,(27.4 ± 9.2) U/L and (35.4 ± 9.8) U/L of control group,and the differences between the two groups were significant (t =3.484,3.228,4.278 and 4.729; P ＜ 0.05).There was no obvious adverse reaction during the treatment course.Conclusion The clinical effect of creatine phosphate on infantile with rotaviral enteritis and myocardial damage is remarkable and safe,and it is worth of clinical application.

Objective To study the appearance of magnetic resonance imaging (MRI) in early stages of cartilage degeneration and to detect its values.Methods Intra articular injection of 5 units of papain causing a reversible loss of cartilage proteoglycan in the New Zealand rabbit knees.Rabbits were scanned with magnetic resonance imaging,using a 0 3 T Hitachi magnet with 16 cm coil.Gradient echo sequences and spin echo sequences were performed in the sagittal planes at 0,24,48 and 72 hours after intra injection of papain.Then signal intensity and thickness of cartilage were measured.The proteoglycan content was measured biochemically and histochemically.Results The cartilage thickness and signal intensity decreased significantly in treated knees compared with control knees at 24 and 48 hours ( P 0 05) after injection of papain.These changes on magenetic resonance (MR) images were consistent with the changes of proteoglycan concentration measured by biochemical analysis and histochemical staining of cartilage.Conclusion It is possible for MRI to detect the early stages of cartilage degeneration.

Objective To investigate the analgesic effect of multi-site multiple paravertebral nerve blocks on patients undergoing radical lung cancer surgery and the impact on their serum indices and prognosis.Methods Ninety-eight cases of patients undergoing thoracoscopic radical lung cancer surgery in our hospital were selected from March 2021 to January 2023 and divided into 2 groups according to the difference in anaesthesia.Among them,42 patients in the study group were treated with preoperative and postoperative multipoint paravertebral nerve block combined with general anaesthesia,while 56 patients in the control group were treated with preoperative multipoint paravertebral nerve block combined with general anaesthesia,and the analgesic effect and other differences between the two groups were compared.Results In the study group,extubation time,recovery time,propofol dosage and postoperative VAS score were(150.2±15.2)min,(19.1±5.1)min,(738.2±36.5)mg and(4.2±0.7)points,respectively.The control group was(151.9±12.6)min,(22.6±7.3)min,(902.1±49.0)mg and(2.3±0.3)min,respectively,and the difference between the two groups was statistically significant(P＜0.05).The differences of heart rate,mean arterial pressure and before and after half an hour after surgery in control group were higher than those in study group,and the differences of norepinephrine,epinephrine and before and after surgery were higher than those in study group,with statistical significance(P＜0.05).The total complication rate of the study group was 7.2％,and that of the control group was 23.2％.The QoR score of the control group was lower than that of the study group,and the difference between the two groups was statistically significant(P＜0.05).Conclusion Preoperative and postoperative multi-point paravertebral nerve block combined with general anaesthesia has a better analgesic effect on patients undergoing radical lung cancer surgery,which can not only reduce the inflammatory reaction of the patients,but also have less impact on their haemodynamic indexes and lower rate of postoperative adverse reactions,and ultimately improve the quality of life of the patients.

Objective To evaluate the effectiveness and safety of quadruple regimen in preventing multi-day cisplatin-based chemotherapy-induced nausea and vomiting(CINV).Methods A total of 112 patients with malignant tumors who underwent cisplatin-based chemotherapy.According to the random number table method,patients were divided into the experimental group and the control group,with 56 cases in each group.The control group received cisplatin-based chemotherapy and triple therapy of fosapreitant dimeglumine,ondansetron hydrochloride and dexamethasone tablets.On this basis,the experimental group was given quadruple therapy containing olanzapine tablets.The occurrence of nausea and vomiting,as well as changes in FLIE and HAD scores were observed in both groups.Results The incidence of nausea and vomiting was lower from day 1(D1)to day 9(D9)after the beginning of chemotherapy in the experimental group than that in the control group(P＜0.05).The incidence of nausea and vomiting in the experimental group was lower than that in the control group.On D9 after the beginning of chemotherapy,the nausea score,vomiting score and total score of FILE were higher in the experimental group than those in the control group(P＜0.05).There were no significant differences in depression or anxiety score and incidence of adverse reactions on D1 and D9 after the beginning of chemotherapy between the two groups(P＞0.05).Conclusion The quadruple antiemetic regimen can improve the control rate of CINV induced by multi-day cisplatin-based chemotherapy,especially for the control of delayed nausea and vomiting,and improve the quality of life of patients during chemotherapy,with good safety.

Objective To explore the application effect of preoperative interview by collective multidisciplinary education model in patients with breast cancer.Methods 126 patients with breast cancer, having undergone radical surgery from February 2015 to February. 2016, were selected and divided, by random number table method, into observation group and control group, each with 63 cases. Traditional mode of preoperative interview was conducted to patients in the control group, while preoperative interview by collective multidisciplinary education model was conducted to patients in the observation group. Anxiety, depression, stress response and satisfaction toward nursing between patients in the two groups were compared before and after intervention.Results After the interview, scores of anxiety and depression of patients in the observation group were (11.2±1.5) and (15.9±0.8) points, while the scores in the control group were (12.5±1.3) and (22.4±1.4) (t=2.032,5.007;P<0.01). Relief of anxiety and depression in the observation group was significantly better than that in the control group (P<0.05). Inside the operating room, before anesthesia was done, heart rate and systolic pressure of patients in the observation group were (71.5±3.9) time/min and (127.3±10.8) mmHg, all lower than that in the control group, which were (81.2±4.7) time/min and (145.2±12.6) mmHg (t=2.975 and 3.382,P<0.05). Satisfaction toward nursing in the observation group was 96.8%, higher than that in the control group, 82.5% (χ2=6.892,P<0.01).Conclusions Preoperative interview by collective multidisciplinary education model to patients with breast cancer can reduce their anxiety and depression, relieve stress response and improve satisfaction towards nursing.

Objective:To explore the characteristics of postoperative hemodynamic changes in patients with early allograft dysfunction (EAD), and to provide clinical imaging support for the early diagnosis of EAD.Methods:A total of 907 patients who underwent liver transplantation in Tianjin First Central Hospital from December 2012 to June 2021 were retrospectively selected, and they were divided into EAD group (361 cases) and non-EAD group (546 cases) according to EAD diagnostic criteria. The peak systolic velocity(PSV) of the hepatic artery, end-diastolic velocity(EDV) of the hepatic artery, resistance index(RI), S/D(PSV/EDV), diameter of the portal vein(PVD), velocity of the portal vein(PVV), diameter of the middle hepatic vein(MHVD), velocity of the middle hepatic vein(MHVV), the diameter of the right hepatic vein(RHVD), and the velocity of the right hepatic vein (RHVV) were collected from 1 to 7 days after operation (a total of 5 573 ultrasound examination results), and the differences in ultrasound hemodynamic parameters were compared between the two groups. The correlation of S/D<2, PSV<25 cm/s, PVV<15 cm/s, MHVV or RHVV<15 cm/s within 3 days after operation with the occurence of EAO were analyzed by multivariate Logistic regression analysis.Results:①The PSV and EDV of the hepatic artery in the EAD group and the non-EAD group showed a slow upward trend at 1-7 days after operation, while the hepatic artery RI and PVV showed a downward trend, the MHVV and RHVV did not fluctuate significantly. ②The hepatic artery in the EAD group showed low-resistance blood flow in the early postoperative period, and the EDV were significantly higher than that in the non-EAD group on 1 d, 2 d, 3 d and 5 d, RI was significantly lower than that of the non-EAD group (all P<0.05); At 4 d, 6 d and 7 d, there was no significant differences of EDV and RI between the two groups(all P>0.05). The PSV of the EAD group was higher than that of the non-EAD group on 3 d ( P<0.05). Among the parameters of portal vein blood flow, the PVV in the EAD group was significantly higher than that in the non-EAD group on 1 d ( P<0.05), and there was no significant difference of PVD between the two groups at day 1-7. Among the parameters of hepatic venous blood flow, the MHVV and RHVV in the EAD group were significantly lower than those in the non-EAD group (all P<0.05), there was no significant difference between the two groups of MHVD and RHVD at 1-7 days. ③The incidence of grafted hepatic artery S/D<2 within 3 days after operation in EAD group was higher than that in non-EAD group. Binary Logistic regression multivariate analysis showed that the occurrence of grafted hepatic artery S/D<2 within 3 days after operation was significantly correlated with the occurrence of EAD[Exp(B)=1.878, P<0.05]. Conclusions:Patients who develop EAD after liver transplantation show low-resistance blood flow in the hepatic artery during the perioperative period, and the occurrence of hepatic artery S/D<2 within 3 days after operation can early predict the occurrence of EAD.

Objective:To investigate the correlation between Doppler ultrasound parameters and pressure gradient of portal vein in pediatric liver transplant patients, and to analyze the diagnostic value of Doppler ultrasound for portal vein stenosis.Methods:This retrospective study involved the data from 92 pediatric liver transplant patients in Tianjin First Central Hospital from June 2014 to September 2021, who underwent pressure gradient measurement. The collected ultrasonic parameters included the diameter and flow velocity of the native portal vein, the portal vein anastomosis, and the donor portal vein. The anastomotic stenosis rate=(the native portal vein diameter–the portal vein anastomosis diameter)/the native portal vein diameter, the velocity ratio=the portal vein anastomosis velocity /the native portal vein velocity, the velocity difference=the portal vein anastomosis velocity–the native portal vein velocity. According to the diagnostic standard of portal vein stenosis, pressure gradient more than 5 mmHg was the portal vein stenosis group, and the pressure gradient less than 5 mmHg was the non-stenosis group. The correlation and differences between ultrasonic parameters and pressure gradient were analyzed. ROC curve was used to evaluate the diagnostic efficiency of each parameter.Results:Firstly, there was a positive correlation between pressure gradient and the portal vein anastomosis velocity, the velocity difference and the velocity ratio ( r=0.521, 0.531, 0.417; all P<0.001). And there was a negative correlation between pressure gradient and the anastomotic diameter ( r=-0.284, P=0.004). Secondly, the portal vein anastomotic velocity, velocity difference and velocity ratio in stenosis group were significantly higher than those in non-stenosis group [135.5(111.0, 169.0)cm/s vs 103.7(72.9, 118.7)cm/s, (112.2±40.3)cm/s vs (67.9±30.5)cm/s, 5.56(3.73, 7.26) vs 3.85(2.78, 4.70); all P≤0.001]; Furthermore, by ROC curve analysis, the cut-off value, the area under the ROC curve, Jordan index, accuracy, sensitivity and specificity of each parameter for the diagnosis of portal vein stenosis were: the anastomotic velocity 124.5 cm/s, 0.814, 0.592, 80.0%, 65.5% and 93.7%; velocity ratio 5.67, 0.760, 0.488, 73.0%, 48.8% and 100%; velocity difference 107.25 cm/s, 0.797, 0.511, 76.0%, 51.9% and 100%. Conclusions:The anastomosis velocity, velocity difference and velocity ratio of portal vein in pediatric liver transplant patients are correlated with the pressure gradient, and there is higher accuracy and specificity of each parameter for diagnosing portal vein stenosis, but the sensitivity is slightly lower.

Objective:To investigate the expression of IGF1R-Ras and RAGE-HMGB1 signaling pathways in colorectal cancer patients with type 2 diabetes mellitus and their significance.Methods:The resected cancer tissues were obtained from 59 patients with colorectal cancer (CRC), including 29 patients with type 2 diabetes mellitus (CRC/DM group) and 30 with CRC alone (CRC group). The expressions of IGF1R, Ras, RAGE and HMGB1 in cancer tissues were detected by immunohistochemistry. The differences between the two groups were compared and the relationship between the expression and clinicopathological characteristics was analyzed.Results:In CRC/DM group, the positive rates of IGF1R and Ras were both 65.5% (19/29), and 51.7% (15/29) patients had IGF1R+ Ras+ immunophenotype, which were significantly higher than those in CRC group [33.3% (10/30), 36.7% (11/30) and 20.0% (6/30); P=0.013, 0.027 and 0.011, respectively]. The expression of IGF1R and Ras in CRC / DM group was positively correlated ( r=0.479, P=0.017). The positive rate of RAGE expression in CRC group and CRC/DM group was 70.0% (21/30) and 72.4% (21/29) respectively, and the positive rate of HMGB1 expression was 46.7% (14/30) and 58.6% (17/29) respectively, neither was observed with significant difference ( P=0.358 and 0.838). However, the proportion of patients with RAGE+ HMGB1+ immunophenotype in CRC/DM group [55.2% (16/29)] was higher than that in CRC Group [26.7% (8/30)] which was statistically significant ( P=0.026), and the expression of both proteins was positively correlated in CRC/DM group ( r=0.578, P=0.003). The clinicopathological analysis showed that in both groups the expression of IGF1R, Ras, RAGE and HMGB1 had no correlation with the sex, age, differentiation degree, tumor length, T stage and lymph node metastasis ( P>0.05). Conclusion:Both IGF1R-Ras and RAGE-HMGB1 pathways may be involved in the oncogenesis of colorectal cancer in patients with type 2 diabetes.

Objective:To investigate the expression of IGF1R-Ras and RAGE-HMGB1 signaling pathways in colorectal cancer patients with type 2 diabetes mellitus and their significance.Methods:The resected cancer tissues were obtained from 59 patients with colorectal cancer (CRC), including 29 patients with type 2 diabetes mellitus (CRC/DM group) and 30 with CRC alone (CRC group). The expressions of IGF1R, Ras, RAGE and HMGB1 in cancer tissues were detected by immunohistochemistry. The differences between the two groups were compared and the relationship between the expression and clinicopathological characteristics was analyzed.Results:In CRC/DM group, the positive rates of IGF1R and Ras were both 65.5% (19/29), and 51.7% (15/29) patients had IGF1R+ Ras+ immunophenotype, which were significantly higher than those in CRC group [33.3% (10/30), 36.7% (11/30) and 20.0% (6/30); P=0.013, 0.027 and 0.011, respectively]. The expression of IGF1R and Ras in CRC / DM group was positively correlated ( r=0.479, P=0.017). The positive rate of RAGE expression in CRC group and CRC/DM group was 70.0% (21/30) and 72.4% (21/29) respectively, and the positive rate of HMGB1 expression was 46.7% (14/30) and 58.6% (17/29) respectively, neither was observed with significant difference ( P=0.358 and 0.838). However, the proportion of patients with RAGE+ HMGB1+ immunophenotype in CRC/DM group [55.2% (16/29)] was higher than that in CRC Group [26.7% (8/30)] which was statistically significant ( P=0.026), and the expression of both proteins was positively correlated in CRC/DM group ( r=0.578, P=0.003). The clinicopathological analysis showed that in both groups the expression of IGF1R, Ras, RAGE and HMGB1 had no correlation with the sex, age, differentiation degree, tumor length, T stage and lymph node metastasis ( P>0.05). Conclusion:Both IGF1R-Ras and RAGE-HMGB1 pathways may be involved in the oncogenesis of colorectal cancer in patients with type 2 diabetes.

Objective:To obtain the normal reference range of hemodynamic ultrasound parameters after pediatric liver transplantation through big data query and statistical analysis, and compare their changes with age.Methods:The clinical liver transplantation ultrasound imaging database software V1.0 independently developed by Tianjin First Central Hospital was used to query the ultrasound hemodynamic parameters of 0-14 years old pediatric patients after parental liver transplantation from December 2012 to December 2022, including portal vein diameter (PVD) on the 1st day, 7th day, 1st month, 6th month, 1st year, 5th year, and 10th year after surgery. The changes in ultrasound blood flow parameters such as portal vein velocity (PVV), hepatic artery peak velocity (S), hepatic artery end diastolic velocity (D), and left hepatic vein velocity (LHVV) with postoperative time in different age groups were analyzed, the differences between age groups were compared, and statistical analysis was perform to obtain the 95% reference value range for each parameter.Results:A total of 731 pediatric patients aged 0-14 years who underwent parental liver transplantation were included in this study, with a total of 5 283 monitoring results. The ultrasound hemodynamic parameters PVV, hepatic artery S, D, and LHVV were highest at 7th day after surgery, and gradually showed a sustained and slightly decreasing trend with the prolongation of postoperative time. At the same time, there was no statistically significant difference in PVV, hepatic artery S, D, and LHVV among different age groups (all P>0.05). Conclusions:This study obtains the trend of ultrasound hemodynamic parameters after pediatric liver transplantation with prolonged follow-up time, and compared them among different age groups.After pediatric liver transplantation, there is no significant change in liver hemodynamic parameters with increasing age. Obtaining reference value ranges for various parameters in different age groups is of great clinical significance for early detection and diagnosis of postoperative vascular complications. Pediatric liver transplantation is more complex than adult liver transplantation, and in clinical monitoring, more attention should be paid to the dynamic changes of transplanted liver blood flow, combining with individual patient status, to provide imaging support for clinical diagnosis.