Objective:To construct a risk prediction model for postoperative incision infection in patients with rectal cancer undergoing ileostomy reversal surgery and to validate this model.Methods:A retrospective study was conducted on 700 patients who underwent ileostomy at The First Affiliated Hospital of Wenzhou Medical University. The patients were randomly divided into a modeling group ( n = 490) and a validation group ( n = 210) in a 7:3 ratio. The incidence of incision infection was recorded, and logistic multiple regression analysis was performed on various factors that may affect incision infection. A predictive model was constructed, and the application value of the predictive model was assessed. Results:Based on the occurrence of postoperative incision infection, patients in the modeling group who underwent ileostomy reversal surgery were divided into an infection group ( n = 61) and a non-infection group ( n = 429). There were no statistically significant differences between the two groups in terms of sex, age, body mass index, history of smoking, history of hypertension, history of immune system diseases, tumor, node, and metastasis staging, history of abdominal surgery, preoperative albumin levels, intraoperative hypothermia, and intraoperative blood loss (all P > 0.05). However, the proportion of patients with a history of diabetes was higher in the infection group [27.87% (17/61)] compared with the non-infection group [5.59% (24/429)]. The proportion of patients with a surgical duration > 90 minutes was also higher in the infection group [70.49% (43/61)] compared with the non-infection group [49.88% (214/429)]. Additionally, the proportion of patients with postoperative subcutaneous drainage was lower in the infection group [16.39% (10/61)] than in the non-infection group [40.56% (174/429)]. The proportion of patients with a history of radiotherapy and chemotherapy was higher in the infection group [75.41% (46/61)] compared with the non-infection group [53.15% (228/429)]. The proportion of patients with peristomal dermatitis was higher in the infection group [31.15% (19/61)] than in the non-infection group [4.20% (18/429)]. All these differences were statistically significant ( χ2 = 34.56, 9.09, 13.30, 10.74, 51.78, all P < 0.05). A history of diabetes, postoperative subcutaneous drainage, surgical duration, a history of radiotherapy and chemotherapy, and peristomal dermatitis were included in the regression model (all P < 0.05). Among these, a history of diabetes, peristomal dermatitis, surgical duration ≥ 90 minutes, and a history of radiotherapy and chemotherapy were identified as independent risk factors, while postoperative subcutaneous drainage was identified as a protective factor. The risk prediction model was constructed as follows: P = -3.791 + 2.594 × a history of diabetes + 1.839 × surgical duration - 2.261 × postoperative subcutaneous drainage + 2.673 × a history of radiotherapy and chemotherapy + 2.765 × peristomal dermatitis. The prediction of the nomogram model for the risk of incision infection after ileostomy reversal surgery in the modeling group showed an area under the receiver operating characteristic curve of 0.931 ( P < 0.001, 95% CI: 0.847-0.983), with a sensitivity of 83.41% and a specificity of 79.91%. The receiver operating characteristic curve results for the validation group indicated an area under the curve of 0.891 ( P < 0.001, 95% CI: 0.821-0.967), with a sensitivity of 75.00% and a specificity of 94.90%. Conclusions:A history of diabetes, peristomal dermatitis, surgical duration ≥ 90 minutes, and a history of radiotherapy and chemotherapy are independent risk factors for incision infection after ileostomy reversal surgery, while postoperative subcutaneous drainage is a protective factor. Constructing a predictive model based on these factors shows good predictive value for the occurrence of incision infection after ileostomy reversal surgery and needs further clinical investigation.

Objective:To construct a risk prediction model for postoperative incision infection in patients with rectal cancer undergoing ileostomy reversal surgery and to validate this model.Methods:A retrospective study was conducted on 700 patients who underwent ileostomy at The First Affiliated Hospital of Wenzhou Medical University. The patients were randomly divided into a modeling group ( n = 490) and a validation group ( n = 210) in a 7:3 ratio. The incidence of incision infection was recorded, and logistic multiple regression analysis was performed on various factors that may affect incision infection. A predictive model was constructed, and the application value of the predictive model was assessed. Results:Based on the occurrence of postoperative incision infection, patients in the modeling group who underwent ileostomy reversal surgery were divided into an infection group ( n = 61) and a non-infection group ( n = 429). There were no statistically significant differences between the two groups in terms of sex, age, body mass index, history of smoking, history of hypertension, history of immune system diseases, tumor, node, and metastasis staging, history of abdominal surgery, preoperative albumin levels, intraoperative hypothermia, and intraoperative blood loss (all P > 0.05). However, the proportion of patients with a history of diabetes was higher in the infection group [27.87% (17/61)] compared with the non-infection group [5.59% (24/429)]. The proportion of patients with a surgical duration > 90 minutes was also higher in the infection group [70.49% (43/61)] compared with the non-infection group [49.88% (214/429)]. Additionally, the proportion of patients with postoperative subcutaneous drainage was lower in the infection group [16.39% (10/61)] than in the non-infection group [40.56% (174/429)]. The proportion of patients with a history of radiotherapy and chemotherapy was higher in the infection group [75.41% (46/61)] compared with the non-infection group [53.15% (228/429)]. The proportion of patients with peristomal dermatitis was higher in the infection group [31.15% (19/61)] than in the non-infection group [4.20% (18/429)]. All these differences were statistically significant ( χ2 = 34.56, 9.09, 13.30, 10.74, 51.78, all P < 0.05). A history of diabetes, postoperative subcutaneous drainage, surgical duration, a history of radiotherapy and chemotherapy, and peristomal dermatitis were included in the regression model (all P < 0.05). Among these, a history of diabetes, peristomal dermatitis, surgical duration ≥ 90 minutes, and a history of radiotherapy and chemotherapy were identified as independent risk factors, while postoperative subcutaneous drainage was identified as a protective factor. The risk prediction model was constructed as follows: P = -3.791 + 2.594 × a history of diabetes + 1.839 × surgical duration - 2.261 × postoperative subcutaneous drainage + 2.673 × a history of radiotherapy and chemotherapy + 2.765 × peristomal dermatitis. The prediction of the nomogram model for the risk of incision infection after ileostomy reversal surgery in the modeling group showed an area under the receiver operating characteristic curve of 0.931 ( P < 0.001, 95% CI: 0.847-0.983), with a sensitivity of 83.41% and a specificity of 79.91%. The receiver operating characteristic curve results for the validation group indicated an area under the curve of 0.891 ( P < 0.001, 95% CI: 0.821-0.967), with a sensitivity of 75.00% and a specificity of 94.90%. Conclusions:A history of diabetes, peristomal dermatitis, surgical duration ≥ 90 minutes, and a history of radiotherapy and chemotherapy are independent risk factors for incision infection after ileostomy reversal surgery, while postoperative subcutaneous drainage is a protective factor. Constructing a predictive model based on these factors shows good predictive value for the occurrence of incision infection after ileostomy reversal surgery and needs further clinical investigation.

Objective: To understand the characteristic of height growth among preschool children with normal physique, overweight and obese, and in order to provide basis for proper physical growth intervention of preschool children. Methods: Cluster sampling method was used and preschool children of kindergartens in 7 cities were selected, height and weight was measured, the information of birth date and sex were collected by parents’ questionnaires. The "WHO Child Growth Standards" was used for evaluate children’s height and body mass index. ANOVA analysis and Wilcoxon rank sum test were used for statistic analysis. Results: There were 2 479 children who were normal weight, overweight and obese at baseline and were followed up for 2 years. The detection rate of Conclusion Parents and practitioners in MCH should pay attention to the children’s height growth, especially on overweight and obese children. More in-depth research are needed to explore the relationship between children’s height and physique.

Objective:To investigate the prevalence and risk factors of depression in patients with acute ST-segment elevation myocardial infarction(STEMI) after percutaneous coronary intervention(PCI).Methods:From January 2019 to December 2019, 205 patients with STEMI who underwent PCI were selected randomly in Department of Cardiology of Heilongjiang Provincial Hospital.And 200 health examined people from our hospital at the same time were selected as health control group.The Zung self-rating depression scale(SDS) was used to score the depression in STEMI patients one week after PCI.The social demographic data were investigated, including age, gender, education status, place of residence, medical payments, monthly income, marital status, smoking history, drinking history, diabetic history, cardiovascular and cerebrovascular diseases history.The clinical indicators were measured, including height, weight, waist circumference(WC), hip circumference(HC), body mass index(BMI), waist-hip rate(WHR), fasting plasma glucose(FPG), fasting serum insulin(FINS), homeostasis model assessment-insulin resistance index(HOMA-IR), serum total cholesterol(TC), total triglyceride(TG), low density lipoprotein-C(LDL-C), high density lipoprotein-C, (HDL-C), systolic blood pressure(SBP) and diastolic blood pressure(DBP).Results:The prevalence of depression in the STEMI group was obviously higher than that in the control group(17.07% vs.9.50%, χ 2=5.025, P=0.025). There was statistically significant difference in the severity of depression between the two groups(χ 2=8.360, P=0.039). Multivariate Logistic regression analysis showed that the risk factors for depression in order of OR values were FPG, gender(female), age(65 or old), BMI, monthly income(<5 000 RMB), HOMA-IR, self-paying for medical services ( OR=1.894, 1.812, 1.545, 1.428, 1.335, 1.285, 1.202). Conclusion:The prevalence of depression in STEMI patients after PCI is increased.The risk factors for depression include female, old age, obesity, low income, insulin resistance and self-paying for medical services.

Objective To observe the Leu72Met single nucleotide polymorphism (SNP)of ghrelin gene and the relationship with essential hypertension (EH).Methods Polymerase chain reaction -restriction fragment length polymorphism (PCR -RFLP)was used to detect the Leu72Met SNP of ghrelin gene in 210 EH patients and 220 healthy controls.The plasma ghrelin was detected by radioimmunoassay method collected from all subjects. Results There were three types of polymorphism of ghrelin gene at the base site Leu72Met.There were significant differences in the genotypes (CC,CA,AA)and alleles (C,A)between the EH patients and the controls (χ2 =6.054,P =0.048;χ2 =5.866,P =0.015).In EH group,the plasma ghrelin level in subjects who were homozygous CC without mutant was not only significantly lower than those who were heterozygous CA,but also lower than those who were nucleotide homozygous mutant AA (t =-8.738,P =0.000;t =-5.103,P =0.000).The patients with CC genotype had higher SBP (t =4.298,P =0.000;t =2.236,P =0.019)and lower HDL -C (t =-11.682,P =0.000;t =-7.872,P =0.000).The patients with A allele had lower plasma ghrelin (t =-16.264,P =0.000), HDL -C (t =-15.332,P =0.000)and higher SBP(t =3.800,P =0.000),DBP(t =11.895,P =0.000),and LDL -C (t =38.401,P =0.000).Conclusion The Leu72Met SNP of ghrelin gene is significantly related to the susceptibility of EH.Base mutation C to A reduced the incidence of EH.The Leu72Met polymorphism of ghrelin gene is related to the plasma ghrelin,blood pressure and blood lipid metabolism.Base mutation C to A elevated plasma ghrelin,and lowered blood pressure and blood lipid.

Objective To observe the morbidity and clinical characteristics of primary aldosteronism (PA) in newly diagnosed patients with hypertension.Methods 255 patients with newly diagnosed high blood pressure were determined plasma renin activity (PRA),angiotensinⅡ(ATⅡ),aldosterone (PAC),cortisol (COR),adrenocortico-tropic hormone (ACTH)and 24h urinary vanilmandelic acid (VMA).They were examined renal artery color doppler and adrenal 64 row CT scan +enhancement scanning.Results 179 patients (70.20%)were diagnosed essential hypertension (EH).In EH patients,24 cases (13.41%)with hypokalemia.42 patients (16.47%)were diagnosed PA.In PA patients,18 cases (42 .86 %)with hypokalemia,25 cases(5 9 .5 2 % )with unilateral adrenal adenoma. Compared with EH patients,there were higher level of high density lipoprotein (HDL -C)(Z =-2.068,P =0.036),lower level of total cholesterol (TC),low density lipoprotein (LDL -C),fasting plasma glucose (FPG), serum kalium (Z =3.594,P =0.000;Z =2.807,P =0.005;Z =3.499,P =0.000;Z =8.435,P =0.000)in PA patients.The levels of plasma PRA and ATⅡin PA patients were lower than in EH patients(Z =3.673,P =0.000;Z =2.215,P =0.026).The levels of plasma PAC and ARR were higher than in EH patients (Z =8.562,P =0.000;Z =19.871,P =0.000).The minimum value of plasma PAC was 292.1pg/L,the ARR was 376.7 in 42 PA patients. The maximum value of plasma PAC was 311.3pg/L,and the ARR was 291.2.Conclusion There is high detection rate of PA in newly diagnosed hypertension.The unilateral adrenal adenoma is a main cause of PA.Hypokalemia is not common in PA patients.PA has little influence on glucolipid metabolism.ARR has high differential diagnosis accuracy for PA and EH.

OBJECTIVE To delineate a deletional mutation of the Dystrophin gene on the short arm of chromosome X in a family affected with Duchenne/Becker muscular dystrophy. METHODS G-banded karyotyping, multiple ligation probe amplification (MLPA), array-based comparative genomic hybridization(array-CGH) and whole genome exon high-throughput sequencing were employed to delineate the mutation in the family. RESULTS GTG banding has demonstrated deletion of the terminal part of the short arm of chromosome X in the fetus. The same deletion was also found in its mother and maternal grandmother. MLPA analysis has revealed removal of exons 52 to 79 of the Dystrophin gene. A 30 Mb deletion in Xp22.33-p21.1 and a 10 Mb duplication in Xq27.2-q28 were identified by array-CGH and whole genome exon high-throughput sequencing. CONCLUSION The Xp deletion has led to deletion of exons 52 to 79 of the Dystrophin gene in the family. The female carriers also had certain features of Turner syndrome due to the same deletion.
Chromosome Deletion ; Chromosomes, Human, X ; Female ; High-Throughput Nucleotide Sequencing ; Humans ; Muscular Dystrophy, Duchenne ; diagnosis ; genetics ; Nucleic Acid Amplification Techniques ; Pregnancy ; Prenatal Diagnosis

Objective To measure the fasting plasma ghrelin and obestatin concentrations in essential hyper-tension (EH)patients with obesity,and to observe their relationship with blood pressure,obesity index,insulin resist-ance (IR),blood glucose and blood lipid.Methods 68 hypertensive obese patients,60 normotensive obese patients and 65 healthy controls were included in the study.The fasting plasma obestatin and ghrelin were measured using a radioimmunoassay method.The ghrelin/obestatin ratio was calculated.Results Hypertensive obese patients had lower plasma ghrelin and obestatin compared with normotensive obese patients (t =3.771,P <0.01;t =4.373,P <0.01) and controls (t =16.451,P <0.01;t =17.862,P <0.01).Normotensive obese patients had lower plasma ghrelin and obestatin compared with controls (t =13.121,P <0.01;t =13.686,P <0.01 ).Hypertensive obese patients had higher ghrelin/obestatin ratio than controls (t =7.720,P <0.01).The ghrelin/obestatin ratio in normotensive obese patients was higher than controls (t =4.587,P <0.01).In hypertensive obese group,the plasma ghrelin and obestatin were negatively associated with BMI (r =-0.882,P <0.01;r =-0.806,P <0.01),SBP (r =-0.787,P <0.01;r =-0.837,P <0.01),DBP (r =-0.769,P <0.01;r =-0.810,P <0.01),and the HOMA-IR (r =-0.800, P <0.01;r =-0.810,P <0.01).In normotensive obese group,ghrelin and obestatin were all negatively associated with BMI (r =-0.577,P <0.01;r =-0.372,P <0.01)and HOMA-IR (r =-0.866,P <0.01;r =-0.662,P <0.01).The ghrelin/obestatin ratio was positively associated with BMI (r =0.460,P <0.01)and HOMA-IR (r =0.420,P <0.01).Conclusion The peripheral blood ghrelin,obestatin and ghrelin/obestatin ratio were significantly correlated with EH,obesity and IR.No correlation was observed between ghrelin/obestatin system and blood lipid or blood glucose.

Objective To investigate the relationship between the polymorphisms of angiotensin Ⅱ receptor gene and the risk of primary aldosteronism (PA).Methods Polymerase chain reaction -restriction fragment length polymorphism (PCR -RFLP)was used to examine the 1 1 66A /C polymorphism of AT1 R gene and 1 675A /G poly-morphism of AT2R gene in 85 patients with PA and 1 00 healthy controls.Results There was no significant difference of AT1 R 1 1 66A /C genotypes (AA,AC,CC)and allele (A and C)frequency among patients and controls (χ2 =0.430,P =0.806).There was obvious difference of AT2R 1 675A /G genotypes (AA,AG,GG)and allele (A and G) frequency among two groups (χ2 =6.1 21 ,P =0.01 3).The G allele was higher than A allele in PA group (χ2 =6.767,P =0.009).Conclusion Homogenic mutation of 1 675A /G site in AT2R gene may be one of risk factors of PA.

Twenty-seven patients with subclinical hyperthyroidism(SH)complicated by paroxysmal atrial fibrillation(PAF)were treated with methimazole plus bisoprolol.All patients were examined by Doppler echocardiogram and 24 h ambulatory electrocardiograms before and 3 months after treatment.Serum FT3,FT4,and TSH levels were measured with RIA.The results showed that low-dose methimazole therapy could improve the left ventricular diastolic function(P < 0.01)and help maintain sinus rhythm.The incidence of subclinical hypothyroidism was low.Low-dose methimazole was effective and safe in patients with SH complicated by PAF.