Early-onset colorectal cancer (EOCRC) shows a different epidemiological trend compared to later-onset colorectal cancer, with its incidence rising in most regions and countries worldwide. However, the reasons behind this trend remain unclear. The etiology of EOCRC is complex and could involve both genetic and environmental factors. Apart from Lynch syndrome and Familial Adenomatous Polyposis, sporadic EOCRC exhibits a broad spectrum of pathogenic germline mutations, genetic polymorphisms, methylation changes, and chromosomal instability. Early-life exposures and environmental risk factors, including lifestyle and dietary risk factors, have been found to be associated with EOCRC risk. Meanwhile, specific chronic diseases, such as inflammatory bowel disease, diabetes, and metabolic syndrome, have been associated with EOCRC. Interactions between genetic and environmental risk factors in EOCRC have also been explored. Here we present findings from a narrative review of epidemiological studies on the assessment of early-life exposures, of EOCRC-specific environmental factors, and their interactions with susceptible loci. We also present results from EOCRC-specific genome-wide association studies that could be used to perform Mendelian randomization analyses to ascertain potential causal links between environmental factors and EOCRC.
Humans ; Colorectal Neoplasms/etiology* ; Risk Factors ; Genome-Wide Association Study ; Genetic Predisposition to Disease/genetics*

Objective:To investigate the clinical characteristics of residual dizziness（RD） after repositioning in patients with benign paroxysmal positional vertigo（BPPV）, identify its potential risk factors, and develop a predictive risk model. Methods:A total of 137 patients diagnosed with BPPV at the First Affiliated Hospital of Xi'an Jiaotong University between January 2023 and June 2023 were enrolled. Based on the presence or absence of subjective discomfort within 3 months after successful repositioning, patients were divided into the non-RD group（NRD, n=93） and the RD group（n=44）. Differences in demographic characteristics, comorbidities, and disease-related features were compared between groups. Multivariate logistic regression analysis was used to identify independent risk factors for RD, and a nomogram was constructed based on these factors. The predictive performance of the model was assessed using the area under the curve（AUC）. Results:The RD group showed significantly higher values in body mass index, prevalence of diabetes and motion sickness history, dizziness duration before repositioning, history of repositioning at external hospitals, number of treatments, and recurrence（all P<0.001）. Multivariate logistic regression revealed that diabetes（adjusted OR=8.73, P=0.039）, motion sickness history（adjusted OR=23.08, P<0.001）, dizziness duration ≥30 days before repositioning（adjusted OR=15.16, P<0.001）, and recurrence（adjusted OR=15.72, P=0.001） were independent risk factors for RD. The nomogram model based on these variables demonstrated good predictive ability, with an AUC of 0.804（95%CI 0.684-0.924）. Conclusion:Diabetes, motion sickness history, dizziness duration ≥30 days, and recurrence are independent risk factors for RD after repositioning in patients with BPPV. The nomogram model based on these variables shows good predictive performance, with recurrence having the highest predictive value. This model can aid in early identification of high-risk patients and guide individualized intervention strategies.
Humans ; Nomograms ; Benign Paroxysmal Positional Vertigo/therapy* ; Dizziness/etiology* ; Risk Factors ; Risk Assessment ; Multivariate Analysis ; Male ; Female ; Logistic Models ; Middle Aged ; Patient Positioning ; Adult

Objective To analyze the predictive value of serum levels of procalcitonin(PCT)and cytokines on the prognosis of patients with COVID-19 at admission.Methods From November 2022 to February 2023,patients diagnosed with COVID-19 who were admitted to Beijing Chest Hospital were enrolled.Chemiluminescence was used to detect serum PCT levels,and flow microsphere array was used to detect serum cytokines IL-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17A,IL-17F,IL-22,TNF-α,TNF-β,IFN-γ level.ICU admission,mechanical ventilation and in-hospital death were defined as poor prognosis.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.Results A total of 176 patients with complete data were included,including 134 in the PCT-normal group and 42 in the PCT-elevated group,with a median age of 71.50 years and 71.59%males.Patients in the PCT elevated-group had significantly higher rates of ICU admission(38.41%vs.13.11%,P<0.05),mechanical ventilation(76.92%vs.24.59%,P<0.001)and in-hospital mortality(38.46%vs.6.56%,P<0.001)were significantly higher than those in the PCT-normal group.Serum levels of cytokines IL-6(7.40 pg/mL vs.4.78 pg/mL,P = 0.033 4)and IL-8(10.97 pg/mL vs.5.92 pg/mL,P<0.001)were significantly higher in patients with poor prognosis than in those with good prognosis.The area under the curve for PCT,IL-6,and IL-8 to predict poor prognosis in COVID-19 patients was 0.687,0.660,and 0.746,respectively;sensitivity was 52.78%,55.17%,and 72.41%,respectively;and specificity was 81.58%,74.19%,and 74.19%,respectively,as calculated from the ROC curve.When PCT,IL-6 and IL-8 jointly predict the prognosis of COVID-19 patients,the area under the curve is 0.764,the sensitivity is 70.00%,and the specificity is 80.00%.Conclusion Serum PCT and cytokines IL-6 and IL-8 could be used as predictive markers for poor prognosis in patients with COVID-19.

Objective:To analyze clinical, immunoserological, and therapeutic features of patients with anti-p200 pemphigoid.Methods:Clinical data were collected from patients with confirmed anti-p200 pemphigoid at the Hospital of Dermatology, Chinese Academy of Medical Sciences from January 2015 to February 2024. Their clinical, immunoserological, and therapeutic characteristics were retrospectively analyzed.Results:A total of 35 patients were included, with a male-to-female ratio of 2.5∶1 (25 males and 10 females) and ages of 57.74 ± 17.12 years. Two (5.71%) patients were accompanied by psoriasis. In these patients, anti-p200 pemphigoid exhibited heterogeneous clinical phenotypes, mimicking classic bullous pemphigoid (20 cases, 57.14%), linear IgA bullous dermatosis (8 cases, 22.86%), or eczema (4 cases, 11.43%). The positive rates of direct immunofluorescence (DIF), indirect immunofluorescence on salt-split skin (ss-IIF), Western blot analysis with dermal extracts as substrates, and Western blot analysis with laminin γ1 C-terminal region (Lnγ1C) as substrates were 100% (24/24), 82.86% (29/35), 100% (35/35), and 80.64% (25/31), respectively. Among the 35 patients, treatment and follow-up information was available for analysis in 33. Six patients (18.18%) received non-glucocorticoid systemic therapy and topical glucocorticoid therapy, with a follow-up period ( M [ Q1, Q3]) of 19.50 (6.50, 69.25) months, and 1 withdrew the drugs. Sixteen patients received systemic glucocorticoids combined with traditional anti-inflammatory drugs, with a follow-up period of 13.50 (4.25, 18.00) months, the initial dose of glucocorticoids was equivalent to 0.30 - 0.50 mg·kg -1·d -1 of prednisone, and the time to disease control was 15.31 ± 5.23 days; among the 16 patients, 3 experienced fluctuations in disease condition which were alleviated by adding dapsone, and 1 discontinued glucocorticoids. Five patients (15.15%) received systemic glucocorticoids combined with immunosuppressants, with a follow-up period of 26.00 (14.00, 90.00) months, the initial dose of glucocorticoids was equivalent to 0.50 - 0.75 mg·kg -1·d -1 of prednisone, and the time to disease control was 10.20 ± 3.27 days; among the 5 patients, 2 received maintenance treatment with glucocorticoids (5 - 10 mg/d prednisone), 2 withdrew the drugs, and 1 relapsed after discontinuing glucocorticoids. One patient (3.03%) received systemic glucocorticoids combined with rituximab therapy, with a follow-up period of 53 months, and discontinued glucocorticoids thereafter. One patient (3.03%) received systemic glucocorticoids combined with dupilumab therapy, which proved to be effective. Four patients (12.12%) received systemic glucocorticoids combined with Janus kinase inhibitors, and 3 responded well. Conclusions:Anti-p200 pemphigoid presented a heterogeneous clinical profile in this series of patients, but scarring and milia were rare. Some patients showed negative results in Western blot analysis with Lnγ1C as substrates. The prognosis of anti-p200 pemphigoid was usually favorable, and most patients could achieve complete remission and ultimately discontinue medication.

Objective:To evaluate the protective effect of foam dressing in preventing intraoperative acquired pressure injury (IAPI), and to provide reference basis for prevention and treatment of IAPI during clinical operation.Methods:The clinical data of 455 surgical patients admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University from October 2020 to January 2021 were retrospectively collected. According to whether foam dressing was used at the compression site during operation, the patients were divided into dressing group (101 cases) and control group (354 cases). The two groups were matched with age, body mass index, preoperative Braden and cerebrovascular disease as covariates, and were finally divided into 89 patients in the dressing group and 162 patients in the control group. Logistic regression analysis and stratified analysis were used to comprehensively evaluate the actual effect of foam dressing on the occurrence of IAPI in the surgical patients.Results:Among the 251 patients, there were 14 (15.7%) cases with IAPI in the dressing group and 13 (8.0%) cases in the control group, and the difference was not statistically significant ( χ2=3.41, P>0.05). Among the patients in the prone position, compared to the control group, the dressing group can effectively reduce the risk of IAPI in surgical patients by 77% ( OR=0.23, 95% CI 0.05-0.98, P<0.05). There was no interaction between foam dressing and intraoperative surgical characteristics ( P>0.05). Conclusions:Foam dressing plays a protective role in preventing the occurrence of IAPI in patients undergoing surgery in the prone position. There was no significant protective effect of intraoperative foam dressing in patients with other surgical characteristics.

The central venous access device (CVAD) is widely used in infusion of intravenous high nutrient solution, chemotherapy drugs, rapid infusion, blood transfusion, etc. CVAD is left in the patient′s blood vessels for a long time, although it has certain advantages in intravenous therapy, but also risks associated with it. In the past 20 years, many studies have focused on the mechanism of CVAD on vascular injury, trying to explore its mechanism from a different perspective at the microscopic level of pathophysiology. This article will review the three aspects of acute damage to the blood vessel caused by CVAD catheterization and chronic changes caused by indwelling catheters, analysis of the causes of vascular injury caused by CVAD catheterization, and research on preventing vascular injury caused by CVAD catheterization, aiming at providing reference for clinical intravenous therapy.

Objective To investigate the efficacy and safety of ultrasound-guided polyglycol in patients with scar pregnancy. Methods Thirty-six patients with scarring treated in Third People's Hospital of Hangzhou from November 2014 to November 2016 were selected as subjects. All patients underwent ultrasound-guided polyglycol administration. The results were analyzed and analyzed. The results were analyzed. Gonadotropin (β-HCG) returned to normal time and the occurrence of adverse symptoms. Results The average recovery time, treatment cost, average recovery time and adverse reaction rate of blood β-HCG in the study group were lower than those in the control group, the difference was statistically significant (P<0.05). Conclusion The effect of ultrasound on the injection of polyphenols in patients with scar pregnancy is safe, feasible and easy to be accepted by patients and their families. It has clinical significance.

Objective To explore the expressions of miR-221 and miR-222 in papillary thyroid carcinoma (PTC),and relativi-ties with clinical pathological features.Methods Samples from patients of PCT (43 cases),nodular golter(21 cases),and para-carcinoma thyroid tissues(14 cases),78 cases in total (from 06/2015 to 05/2016,Shaanxi Provincial People’s Hospital) were collected.Real time-PCR tests were carried out,then analyzed in relation to clinical pathology features,and statistical a-nalysis was used to evaluate the results.Results The expressions of miR-221 and miR-222 were significantly higher in PTC (11.54±3.37,10.67±2.45)than in nodular golter (3.21±1.12,2.89±1.23)and normal thyroid tissue (2.02±0.76, 1.98±0.34)(t=3.62,3.25;3.27,3.01,all P<0.05),which were significantly related with Regional lymph node metasta-sis,tumor invasion coated,distant metastasis and clinical stage (P<0.05),while not related with the gender,age,or size of the tumor of the patients (P>0.05),and no differences were found in nodular golter and in normal thyroid tissue (t=0.91, 0.79,P>0.05).Conclusion miR-221 and miR-222 could be considered as a specific molecular marker of PTC,may play an important role in the diagnosis and treatment on PTC.

Objective To investigate the relationship between serum prealbumin (PA) and inflammation in acute myocardial infarction (AMI) patients. Methods A prospective observational study was conducted. AMI patients hospitalized in the cardiovascular department of the General Hospital of Chinese People's Armed Police Forces from June 2014 to June 2016 were enrolled in the study. At the same time, healthy cases were enrolled as control. Venous blood was taken from patients at admission. Serum PA was detected by immune projection turbidimetry method and high-sensitivity C-reactive protein (hs-CRP) was measured by latex enhanced immune turbidimetry. High-sensitivity cardiac troponin T (hs-cTnT), and interleukin (IL-6, IL-8) was measured by electrochemical luminescence method. Creatine kinase-MB isoenzyme (CK-MB) was detected by rate method. PA, inflammatory factor and myocardial enzyme were compared between two groups. The correlation between PA and inflammatory factors was analyzed by Pearson linear correlation; The diagnostic value of PA was analyzed by receiver operating characteristic (ROC) curve. Results 173 AMI patients and 86 healthy controls were enrolled in the study. There were no significant differences in gender, age, history of smoking, hypertension and diabetes. Compared with the control, the levels of serum PA in AMI patients was lower [PA (g/L): 0.215±0.056 vs. 0.280±0.057], hs-CRP, IL-6, IL-8, hs-cTnT and CK-MB were higher [hs-CRP (mg/L): 6.63±3.52 vs. 2.25±1.45, IL-6 (ng/L): 38.03±22.43 vs. 6.13±3.38, IL-8 (ng/L): 295.61±98.70 vs. 17.24±7.31, hs-cTnT (μg/L): 4.789±2.874 vs. 0.009±0.008, CK-MB (U/L): 244.48±165.54 vs. 12.20±5.24], the difference was statistical significant (all P < 0.01). It was shown by Pearson correlation analysis that the levels of PA were negatively related to hs-CRP, IL-6 and IL-8 (r = -0.562, -0.591, -0.548, all P <0.05). The PA level had no correlation with hs-cTnT and CK-MB (r = -0.018, -0.149, both P > 0.05). It was shown by ROC curve analysis that area under ROC curve (AUC) of PA for diagnosis of AMI was 0.783±0.039, and the 95% confidence interval (95%CI) was 0.706-0.860 (P < 0.05). When the cut-off value was 0.190 g/L, the sensitivity was 29.63%, and the specificity was 62.22%. Conclusion PA may be involved in the inflammatory process of AMI and had a diagnostic value for AMI.

Objective:To optimize the compatibility conditions of erigeron injection and study the stability after compatibility. Methods:An orthogonal test was employed using the quantity of insoluble particles and the content of rutin as the indices and tempera-ture, solvent and solvent amount as the influencing factors. The results were comprehensively analyzed. According to the results of the orthogonal test, three batches of samples were prepared and observed the stability in 24 hours, including the changes in the number of insoluble particles, pH and total flavonoid content. Results:The optimal compatibility conditions were as follows:the temperature was 25℃, and 250 ml 0. 9% sodium chloride injection was used as the solvent. The appearance and the insoluble particles showed no sig-nificant changes in 24 hours. The total flavonoid content was also stable in 4 hours, but decreased to some extent after then. Conclu-sion:At the clinical dose, erigeron injection in 250 ml 0. 9% sodium chloride injection can keep stable in 4 hours.