Objective: To detect the level of peripheral blood UL16 binding protein 2 (ULBP2) in patients with colorectal cancer, and study its value on early diagnosis and prognosis evaluation. Methods: Eighty patients with colorectal cancer (colorectal cancer group) and 60 healthy subjects (healthy control group) from May 2016 to May 2019 in Affiliated Dongfeng Hospital, Hubei University of Medicine were selected. Serum expression level of ULBP2 was detected by enzyme-linked immunosorbent assay. The diagnostic efficacy of serum ULBP2 in colorectal cancer was evaluated by receiver operating characteristic (ROC) curve. The influencing factors of survival in patients with colorectal cancer were analyzed by Cox regression model. Kaplan-Meier method was used for drawing the survival curve, and log-rank test method was used for comparison. Results: The serum ULBP2 level in colorectal cancer group was significantly higher than that in healthy control group: (85.52 ± 12.18) ng/L vs. (66.20 ± 8.28) ng/L, and the serum ULBP2 level of stage Ⅰ to Ⅱ in colorectal cancer group was also significantly higher than that in healthy control group: (76.44 ± 7.56) ng/L vs. (66.20 ± 8.28) ng/L, and there were statistical differences (P<0.05). ROC curve analysis result showed that the optimal cut off value of serum ULBP2 for colorectal cancer diagnosis was 79.53 ng/L, and area under curve (AUC) was 0.869, with a sensitivity of 73.75% and a specificity of 91.67%; the optimal cut off value of serum ULBP2 for stage Ⅰ to Ⅱ colorectal cancer diagnosis was 71.86 ng/L, and AUC was 0.827, with a sensitivity of 78.57%, and a specificity of 78.33%. According to the median serum ULBP2 level, the patients were divided into ULBP2 high expression (ULBP2>85.52 ng/L, 38 cases) and ULBP2 low expression (42 cases). The serum expression level of ULBP2 was related to lymph node metastasis and tissue differentiation (P < 0.05). Univariate Cox regression analysis result showed that lymph node metastasis, distant metastasis, tissue differentiation and serum ULBP2 were risk factors of poor prognosis in patients with colorectal cancer (P<0.01 or <0.05); multivariate Cox regression analysis result showed that serum ULBP2 was the independent risk factor of poor prognosis in patients with colorectal cancer (HR = 0.194, 95% CI 0.077 to 0.490, P = 0.001). The median survival time in patients with serum ULBP2 high expression was significantly shorter than that in patients with serum ULBP2 low expression (28 months vs. 50 months), and there was statistical difference (P<0.05). Conclusions Serum ULBP2 can be used as an indicator for early diagnosis and prognostic evaluation in patients with colorectal cancer.

Objective To compare the clinical effects of RPH combined with Milligan and PPH in the treatment of severe mixed hemorrhoids. Methods 168 patients with severe mixed hemorrhoids were assigned to a study group or a control group,84 patients for each group. The control group received PPH therapy,while the study group received RPH combined with Milligan procedure. Results The procedures were completed successfully in all the patients. The postoperative hospital stay and surgical duration were shorter and the amount of bleeding was smaller in the study group than in the control group(P<0.05). Three months after surgery,the rate of compli-cations including urinary retention,anal incontinence,anorectal stenosis,and secondary anal fissure was lower in the study group than in the control group(P < 0.05). The total effective rate was 97.6% in the study group and 85.7% in the control group,with a higher rate in the study group(P<0.05). Anal PSV and EDV values were lower in both groups three months after the procedures as compared with one day before the procedures(P<0.05),and the values were smaller in the study group than in the control group(P<0.05). Conclusions Milligan combined with RPH in the treatment of severe mixed hemorrhoids can reduce hemorrhoids blood flow. This procedure is mini-mally invasive and it can reduce the development of postoperative complications and improve efficacy.

Objective:To investigate the effect of peripheral blood methylation hyaluronoglucosaminidase 2 (HYAL2) before initial chemotherapy in Ⅱ to Ⅲ rectal cancer patients undergoing adjuvant chemotherapy after surgery.Methods:The clinical data of 98 patients with Ⅱ to Ⅲ rectal cancer from May 2019 to May 2021 in Sinopharm Dongfeng General Hospital, Hubei University of Medicine were retrospectively analyzed. All patients underwent adjuvant chemotherapy after radical surgery. The clinical characteristics of patients were record. The peripheral blood level of methylation HYAL2 before initial chemotherapy was detected by real-time fluorescence quantitative polymerase chain reaction. The cut-off value of peripheral blood methylation HYAL2 level was determined by X-tile 3.6.1 software. Multivariate Cox regression was used to analyze the independent risk factors of overall survival (OS) and disease-free survival (DFS) in patients with Ⅱ to Ⅲ rectal cancer. Kaplan-Meier survival curve was drawn to analyze the survival status in Ⅱ to Ⅲ rectal cancer patients with different peripheral blood level of methylation HYAL2. The efficacy of peripheral blood level of methylation HYAL2 in predicting the DFD and OS in patients with Ⅱ to Ⅲ rectal cancer was evaluated by the receiver operating characteristics (ROC) curve.Results:The peripheral blood level of methylation HYAL2 in 98 patients with Ⅱ to Ⅲ rectal cancer before initial chemotherapy was (45.13 ± 12.13)%, and the cut-off for evaluating OS was 43.18% by X-tile 3.6.1 software. Among them, 66 cases were high expression (peripheral blood level of methylation HYAL2 ≥43.18%), and 32 cases were low expression (<43.18%). The tumor diameter and TNM stage were the affect factors of peripheral blood level of methylation HYAL2 in patients with Ⅱ to Ⅲ rectal cancer ( P<0.05); the peripheral blood level of methylation HYAL2 was not related to gender, age, differentiation degree, lymph node metastasis and depth of invasion ( P>0.05). Multivariate Cox regression analysis result showed that TNM stage and peripheral blood level of methylation HYAL2 were the independent risk factors of OS in patients with Ⅱ to Ⅲ rectal cancer ( HR = 0.451 and 1.697, 95% CI 0.204 to 1.001 and 0.309 to 2.787, P<0.05); the peripheral blood level of methylation HYAL2 was an independent risk factor of DFS in patients with Ⅱ to Ⅲ rectal cancer ( HR = 1.027, 95% CI 0.146 to 1.943, P<0.05). Kaplan-Meier survival curve analysis result showed that the median OS and DFS in patients with low peripheral blood level of methylation HYAL2 were significantly longer than those in patients with high peripheral blood level of methylation HYAL2 (29 months vs. 21 months and 26 months vs. 21 months), and there were statistical differences (log-rank χ2 = 12.57 and 8.66, P<0.05). ROC curve analysis result showed that the area under curve (AUC) of peripheral blood level of methylation HYAL2 to predict the OS in patients with Ⅱ to Ⅲ rectal cancer was 0.882 (95% CI 0.801 to 0.938), with the specificity of 65.67% and the sensitivity of 99.45%; the AUC of peripheral blood level of methylation HYAL2 to predict the DFS in patients with Ⅱ to Ⅲ rectal cancer was 0.847 (95% CI 0.760 to 0.913), with the specificity of 62.90% and the sensitivity of 97.22%. Conclusions:The peripheral blood level of methylation HYAL2 before initial chemotherapy is an independent risk factor of prognosis in Ⅱ to Ⅲ rectal cancer patients undergoing adjuvant chemotherapy after surgery, and it can serve as an index for prognostic evaluation.