Objective To analyze survival outcomes and influencing factors among patients with colorectal cancer in Yunnan Province. Methods Clinical data were retrospectively collected from 4 892 patients with colorectal cancer. Survival data were obtained through follow-up. Overall survival (OS) was calculated by using the Kaplan-Meier method. Univariate analysis was performed by applying the log-rank test. Meanwhile, multivariate analysis employed the Cox proportional hazards regression model. Results The 1-, 3-, 5-, and 10-year OS rates for the entire cohort were 91.90%, 74.40%, 64.40%, and 28.70%, respectively. Univariate analysis revealed that age, ethnicity, region, differentiation grade, TNM stage, clinical stage, metastatic status, histological type, and treatment modality (chemotherapy, radiotherapy, and surgery) were associated with patient prognosis (all P<0.05). Multivariate analysis identified age (HR=1.250), region (HR=1.262), differentiation grade (HR=0.761), clinical stage (HR=3.128), and treatment modality (chemotherapy, HR=0.644; radiotherapy, HR=1.605; surgery, HR=0.384) as independent factors affecting survival prognosis in patients with colorectal cancer (all P<0.001). Conclusion Age, region, clinical stage, and treatment modality are independent factors influencing survival among patients with colorectal cancer in Yunnan Province. In clinical practice, these factors should be integrated to develop individualized prevention and treatment strategies, thereby improving patient outcomes.

Objective:To explore the feasibility and safety of sodium bicarbonate solution for flushing in preventing fibrin sheath occlusion in peripherally inserted central catheters (PICC), providing a reference for PICC maintenance.Methods:A randomized controlled study was conducted from June 2022 to September 2023. Convenience sampling was used to select 96 patients who underwent PICC at the Affiliated Tumor Hospital of Guangxi Medical University. The patients were randomly divided into a control group and an observation group. Both groups performed grip strength exercises using a grip ball on the catheterized upper limb. During catheter maintenance, both groups used 10 ml of 0.9% sodium chloride solution for pulsed flushing. The control group used 10 ml of 0.9% sodium chloride solution for positive pressure flushing, while the observation group used 3 ml of 5% sodium bicarbonate solution for positive pressure flushing. The incidence of "mechanical valve" and catheter occlusion, as well as blood bicarbonate concentration and interleukin-6 (IL-6) levels, were recorded on the first day and at 1, 2, 3, 4, and 5 months after catheterization.Results:A total of 92 PICC patients were included, with 45 in the control group, 28 males and 17 females, aged (43.80 ± 2.21) years old, and 47 in the observation group, 29 males and 18 females, aged (43.80 ± 2.25) years old. The total incidence of "mechanical valve" in the observation group was 2.1% (1/47), lower than the control group′s 26.7% (12/45), the difference was statistically significant ( χ2=11.41, P<0.05). The incidence of catheter occlusion in the observation group was 2.1% (1/47), lower than the control group's 15.5% (7/45), the difference was statistically significant ( χ2=5.22, P<0.05). The IL-6 levels in the observation group at 2, 3, 4, and 5 months after catheterization were (4.53 ± 0.62), (4.68 ± 0.59), (4.76 ± 0.57), and (4.83 ± 0.53) ng/L, respectively, lower than the control group (4.83 ± 0.59), (4.95 ± 0.54), (5.21 ± 0.48), and (5.63 ± 0.57) ng/L, the differences were statistically significant ( t values were 2.26-6.86, all P<0.05). There were no significant differences in blood bicarbonate concentration between the two groups at different time points (all P>0.05). Conclusions:Sodium bicarbonate solution for flushing can effectively prevent fibrin sheath blockage of PICC and reduce serum IL-6 levels, making it a safe and effective flushing method.

Objective To provide reference for the clinical use of Baihui acupoint(GV20)in treating diseases,the rules of clinical application of GV20 in ancient literature through data mining technology was analyzed.Methods"Zhong Hua Yi Dian"was searched by computer for relevant papers involving GV20 in the main treatment of illnesses,the main treatment of illnesses by combining other acupoints,and the treatment methods.After organizing the included articles into a database,Microsoft Excel 2021 was used to analyze the frequency of diseases and the use of acupoint pairing,attribution to meridians and special points,and IBM SPSS STATISTIC 27 software was used to analyze the cluster analysis of high-frequency compatible acupoints.Results Valid prescriptions from 209 medical books,including Zhen Jiu Da Cheng(The Great Compendium of Acupuncture and Moxibustion),containing 311 compatible acupoints,were screened and summarized.The main treatment conditions of GV20 mainly included internal medicine,surgery,gynecology,pediatrics and other disciplines,with the brain and liver and gallbladder systems of internal medicine as the main diseases.The top 5 frequency acupoints were Quchi(LI11),Hegu(LI4),Shenting(GV24),Zusanli(ST36),and Shangxing(GV23),and the most frequently involved meridians were Bladder Meridian of Foot-Taiyang,Governor Vessel,and Gallbladder Meridian of Foot-Shaoyang.The compatible acupoints mainly distributed in the head and neck.The special points with the highest frequency of collocation were Five-Shu acupoints,confluent acupoints,and Back-Shu acupoints.In the cluster analysis,the icicle diagram showed 2 effective clusters and the dendrogram 4 clusters of acupoints.Conclusion The main treatment range of GV20 in ancient medical texts is wide,and the main treatment range can be enlarged by pairing,emphasizing the use of moxibustion,which can provide a reference for modern clinical treatment.

Objective:To explore the feasibility and safety of sodium bicarbonate solution for flushing in preventing fibrin sheath occlusion in peripherally inserted central catheters (PICC), providing a reference for PICC maintenance.Methods:A randomized controlled study was conducted from June 2022 to September 2023. Convenience sampling was used to select 96 patients who underwent PICC at the Affiliated Tumor Hospital of Guangxi Medical University. The patients were randomly divided into a control group and an observation group. Both groups performed grip strength exercises using a grip ball on the catheterized upper limb. During catheter maintenance, both groups used 10 ml of 0.9% sodium chloride solution for pulsed flushing. The control group used 10 ml of 0.9% sodium chloride solution for positive pressure flushing, while the observation group used 3 ml of 5% sodium bicarbonate solution for positive pressure flushing. The incidence of "mechanical valve" and catheter occlusion, as well as blood bicarbonate concentration and interleukin-6 (IL-6) levels, were recorded on the first day and at 1, 2, 3, 4, and 5 months after catheterization.Results:A total of 92 PICC patients were included, with 45 in the control group, 28 males and 17 females, aged (43.80 ± 2.21) years old, and 47 in the observation group, 29 males and 18 females, aged (43.80 ± 2.25) years old. The total incidence of "mechanical valve" in the observation group was 2.1% (1/47), lower than the control group′s 26.7% (12/45), the difference was statistically significant ( χ2=11.41, P<0.05). The incidence of catheter occlusion in the observation group was 2.1% (1/47), lower than the control group's 15.5% (7/45), the difference was statistically significant ( χ2=5.22, P<0.05). The IL-6 levels in the observation group at 2, 3, 4, and 5 months after catheterization were (4.53 ± 0.62), (4.68 ± 0.59), (4.76 ± 0.57), and (4.83 ± 0.53) ng/L, respectively, lower than the control group (4.83 ± 0.59), (4.95 ± 0.54), (5.21 ± 0.48), and (5.63 ± 0.57) ng/L, the differences were statistically significant ( t values were 2.26-6.86, all P<0.05). There were no significant differences in blood bicarbonate concentration between the two groups at different time points (all P>0.05). Conclusions:Sodium bicarbonate solution for flushing can effectively prevent fibrin sheath blockage of PICC and reduce serum IL-6 levels, making it a safe and effective flushing method.

Objective:To investigate the effects of chronic persistent hypoxia on hepatic function, histological morphology, and ultrastructure in aged mice, and to evaluate the protective role of pyrroloquinoline quinone(PQQ).Methods:Thirty-two 2-month-old (young group)and thirty-two 18-month-old(aged group)male C57BL6/J mice were each randomly divided into four groups (n=8 per group): normoxia+ normal saline (NS)group, normoxia+ PQQ group, hypoxia+ NS group, and hypoxia+ PQQ group.The normoxia+ NS and normoxia+ PQQ groups were housed under normoxic conditions[fraction of inspired oxygen(FiO 2)=21%], while the hypoxia+ NS and hypoxia+ PQQ groups were continuously exposed to a hypoxic environment[FiO 2=(10±0.5)%]simulated by a custom-made hypoxic chamber, maintaining a constant oxygen concentration for 24 hours per day.The normoxia+ NS and hypoxia+ NS groups received daily intragastric administration of NS, whereas the normoxia+ PQQ and hypoxia+ PQQ groups received daily intragastric administration of PQQ disodium salt(8 mg·kg -1·d -1).After 8 weeks of continuous intervention, blood samples were collected to measure red blood cell count, hemoglobin levels, and liver function-related biochemical indicators.Lung tissues were processed for HE staining, and liver tissues were processed for both HE staining and electron microscopy.The histological and ultrastructural features of each group were observed under light and electron microscopy, respectively, and the differences between the groups were compared and analyzed. Results:Compared with the normoxia+ NS groups, both young and aged hypoxia+ NS groups exhibited significant pulmonary arteriole narrowing( P<0.001), with markedly elevated red blood cell count and hemoglobin levels (all P<0.001), which were not alleviated by PQQ.Compared with the young normoxia+ NS group, the young hypoxia+ NS group showed significantly higher alanine aminotransferase (ALT)and lactate dehydrogenase (LDH)levels( Z=2.72, 2.53, P=0.007, 0.011), whereas the young hypoxia+ PQQ group exhibited LDH levels similar to those of the young normoxia+ NS group.The aged hypoxia+ NS group exhibited significant ALT elevation( t=2.66, P=0.013)compared with the aged normoxia+ NS group.Light microscopy revealed hepatocyte ballooning degeneration, mild fatty accumulation, and focal necrosis around central veins in the young hypoxia+ NS group, while the young hypoxia+ PQQ group exhibited no significant pathological damage but displayed numerous deeply stained binucleated hepatocytes.The aged normoxia+ NS group demonstrated hepatocyte ballooning degeneration and inflammatory cell infiltration around central veins, whereas the aged normoxia+ PQQ group exhibited no obvious pathological damage with scattered deeply stained binucleated hepatocytes.The aged hypoxia+ NS group exhibited significant necrosis following physiological oxygen concentration gradient distribution, while the aged hypoxia+ PQQ group displayed no obvious pathological damage with scattered deeply stained binucleated hepatocytes.Electron microscopy revealed that the aged normoxia+ NS group had reduced mitochondrial electron density ( P<0.001)and less developed rough endoplasmic reticulum compared with the young normoxia+ NS group.The young hypoxia+ NS group exhibited a smaller mitochondrial area( P<0.001), decreased mitochondrial matrix electron density( P<0.001), blurred or absent mitochondrial cristae, inactive rough endoplasmic reticulum, and increased accumulation of glycogen and lipid droplets compared with the young normoxia+ NS group, while the young hypoxia+ PQQ group maintained mitochondrial matrix electron density comparable to the young normoxia+ NS group.The aged hypoxia+ NS group exhibited larger mitochondrial area( P=0.001), decreased mitochondrial matrix electron density( P<0.001), blurred or absent mitochondrial cristae, mitochondrial edema, increased lysosomes, and elevated cytoplasmic electron density compared with the aged normoxia+ NS group.The aged hypoxia+ PQQ group exhibited reduced mitochondrial area( P<0.001)and restored mitochondrial matrix electron density to levels comparable with the aged normoxia+ NS group.The aged normoxia+ PQQ group demonstrated increased mitochondrial matrix electron density compared with the aged normoxia+ NS group( P<0.001). Conclusions:Chronic persistent hypoxia induces hepatic functional, histological and ultrastructural damage in mice, with more pronounced effects in aged animals.PQQ provides a certain degree of protection against these injuries.

Objective:To evaluate the perioperative application effect of enhanced recovery after surgery (ERAS) clinical pathway in percutaneous vertebro plasty (PVP).Methods:The clinical data of 274 patients who underwent PVP treatment for osteoporotic vertebral compression fracture (OVCF) in Beijing Friendship Hospital, Capital Medical University from May 2023 to August 2024 were retrospectively analyzed. The patients were divided into two groups according to the different numbers of surgical segments: the single-segment group ( n=211) and the multisegment group ( n=63). Patients in the single-segment group underwent single-segment surgery, while patients in the multisegment group underwent surgery on ≥2 segments. The core points of the ERAS clinical pathway adopted in this study include perioperative education, pain management, early mobilization, application of "outfast", and joint guidance from the departments of nutrition and rehabilitation. Comparison was made between the two groups of patients in terms of visual analog scale (VAS) scores for low back pain at preoperative, 2 h, 6 h, 24 h postoperatively, and on the day of discharge; Oswestry disability index (ODI) scores preoperatively and on the day of discharge; time to first ambulation postoperatively, total length of hospital stay, postoperative length of stay, perioperative complications, and perioperative application of Opioid consumption. Measurement data were expressed as mean±standard deviation ( ± s), and the independent sample t-test was used for comparison between groups; count data were expressed as cases and percentage, and the Chi-square test was used for comparison between groups. The VAS pain scores at each stage of the perioperative period were evaluated using repeated measures analysis of variance or generalized estimating equations. Results:Compared with that before the operation [(6.17±0.93) points, (6.29±0.83) points], the VAS scores of low back pain of patients in the single-segment group and the multisegment group at 2 hours after surgery [(3.09±0.82) points, (3.27±0.65) points], 6 hours after surgery [(2.60±0.79) points, (2.62±0.55) points], and 24 hours after surgery [(1.89±0.77) points, (1.97±0.72) points] and on the day of discharge [(1.72±0.71) points, (1.81±0.64) points] were significantly decreased, and the differences were statistically significant ( P<0.05). At the same stage, the VAS scores of low back pain in both groups were not statistically significant ( P>0.05). The ODI scores of patients in the single-segment group and the multisegment group on the day of discharge [(24.21±2.35) points, (24.63±3.31) points] were significantly lower than those before the operation [(64.50±4.81) points, (65.52±4.08) points], and the differences were statistically significant ( P<0.05). There were no statistically significant differences in perioperative complications and the proportion of Opioid drug application between the two groups of patients ( P>0.05). Conclusion:For patients with single-segment or multisegment OVCF, PVP surgical treatment under ERAS clinical pathway management can achieve immediate pain relief, early ambulation exercise, and satisfactory perioperative efficacy.

Objective:To explore the risk factors of cement leakage into the spinal canal in percutaneous vertebroplasty (PVP) for spinal metastases.Methods:A retrospective analysis was conducted on the case data of 211 patients with spinal metastases who underwent PVP in the Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University from January 2016 to June 2024. According to the presence or absence of intraspinal bone cement leakage after surgery, the patients were divided into the leakage group ( n=45) and the non-leakage group ( n=166). The clinical data of the two groups, including gender, age, bone mineral density T-score, American Society of Anesthesiologists (ASA) classification, operation time, and bone cement injection volume, were collected and statistically analyzed. Measurement data were expressed as mean±standard deviation ( ± s), and the independent samples t-test was used for comparison between groups; count data were expressed as the number of cases and percentage, and the Chi-square test was used for comparison between groups. Univariate analysis was used to explore the possible risk factors for intraspinal bone cement leakage after PVP, and then the indicators with statistically significant differences in the univariate analysis were included in the multivariate Logistic regression analysis to identify the independent risk factors. Results:A total of 45 patients out of 211 patients with PVP surgery had cement leakage into the spinal canal after surgery, with an incidence rate of 21.3%. There were statistically significant differences between the leakage group and the non-leakage group in terms of whether the posterior wall of the vertebral body was broken, operation time, the injection volume of bone cement, distribution of injured vertebrae, and viscosity of bone cement ( P<0.05). The results of multivariate Logistic regression analysis showed that the broken posterior wall of the vertebral body, large injection volume of bone cement, and low viscosity of bone cement were the independent risk factors for the occurrence of cement leakage into the spinal canal in PVP for spinal metastases ( P<0.05). Conclusion:When PVP surgery is used to treat spinal metastases, broken posterior wall of the vertebral body, large injection volume of bone cement, and low viscosity of bone cement can increase the incidence of postoperative intravertebral cement leakage, and the operation should be performed with caution.

Objective To provide reference for the clinical use of Baihui acupoint(GV20)in treating diseases,the rules of clinical application of GV20 in ancient literature through data mining technology was analyzed.Methods"Zhong Hua Yi Dian"was searched by computer for relevant papers involving GV20 in the main treatment of illnesses,the main treatment of illnesses by combining other acupoints,and the treatment methods.After organizing the included articles into a database,Microsoft Excel 2021 was used to analyze the frequency of diseases and the use of acupoint pairing,attribution to meridians and special points,and IBM SPSS STATISTIC 27 software was used to analyze the cluster analysis of high-frequency compatible acupoints.Results Valid prescriptions from 209 medical books,including Zhen Jiu Da Cheng(The Great Compendium of Acupuncture and Moxibustion),containing 311 compatible acupoints,were screened and summarized.The main treatment conditions of GV20 mainly included internal medicine,surgery,gynecology,pediatrics and other disciplines,with the brain and liver and gallbladder systems of internal medicine as the main diseases.The top 5 frequency acupoints were Quchi(LI11),Hegu(LI4),Shenting(GV24),Zusanli(ST36),and Shangxing(GV23),and the most frequently involved meridians were Bladder Meridian of Foot-Taiyang,Governor Vessel,and Gallbladder Meridian of Foot-Shaoyang.The compatible acupoints mainly distributed in the head and neck.The special points with the highest frequency of collocation were Five-Shu acupoints,confluent acupoints,and Back-Shu acupoints.In the cluster analysis,the icicle diagram showed 2 effective clusters and the dendrogram 4 clusters of acupoints.Conclusion The main treatment range of GV20 in ancient medical texts is wide,and the main treatment range can be enlarged by pairing,emphasizing the use of moxibustion,which can provide a reference for modern clinical treatment.

Objective:To investigate the effects of chronic persistent hypoxia on hepatic function, histological morphology, and ultrastructure in aged mice, and to evaluate the protective role of pyrroloquinoline quinone(PQQ).Methods:Thirty-two 2-month-old (young group)and thirty-two 18-month-old(aged group)male C57BL6/J mice were each randomly divided into four groups (n=8 per group): normoxia+ normal saline (NS)group, normoxia+ PQQ group, hypoxia+ NS group, and hypoxia+ PQQ group.The normoxia+ NS and normoxia+ PQQ groups were housed under normoxic conditions[fraction of inspired oxygen(FiO 2)=21%], while the hypoxia+ NS and hypoxia+ PQQ groups were continuously exposed to a hypoxic environment[FiO 2=(10±0.5)%]simulated by a custom-made hypoxic chamber, maintaining a constant oxygen concentration for 24 hours per day.The normoxia+ NS and hypoxia+ NS groups received daily intragastric administration of NS, whereas the normoxia+ PQQ and hypoxia+ PQQ groups received daily intragastric administration of PQQ disodium salt(8 mg·kg -1·d -1).After 8 weeks of continuous intervention, blood samples were collected to measure red blood cell count, hemoglobin levels, and liver function-related biochemical indicators.Lung tissues were processed for HE staining, and liver tissues were processed for both HE staining and electron microscopy.The histological and ultrastructural features of each group were observed under light and electron microscopy, respectively, and the differences between the groups were compared and analyzed. Results:Compared with the normoxia+ NS groups, both young and aged hypoxia+ NS groups exhibited significant pulmonary arteriole narrowing( P<0.001), with markedly elevated red blood cell count and hemoglobin levels (all P<0.001), which were not alleviated by PQQ.Compared with the young normoxia+ NS group, the young hypoxia+ NS group showed significantly higher alanine aminotransferase (ALT)and lactate dehydrogenase (LDH)levels( Z=2.72, 2.53, P=0.007, 0.011), whereas the young hypoxia+ PQQ group exhibited LDH levels similar to those of the young normoxia+ NS group.The aged hypoxia+ NS group exhibited significant ALT elevation( t=2.66, P=0.013)compared with the aged normoxia+ NS group.Light microscopy revealed hepatocyte ballooning degeneration, mild fatty accumulation, and focal necrosis around central veins in the young hypoxia+ NS group, while the young hypoxia+ PQQ group exhibited no significant pathological damage but displayed numerous deeply stained binucleated hepatocytes.The aged normoxia+ NS group demonstrated hepatocyte ballooning degeneration and inflammatory cell infiltration around central veins, whereas the aged normoxia+ PQQ group exhibited no obvious pathological damage with scattered deeply stained binucleated hepatocytes.The aged hypoxia+ NS group exhibited significant necrosis following physiological oxygen concentration gradient distribution, while the aged hypoxia+ PQQ group displayed no obvious pathological damage with scattered deeply stained binucleated hepatocytes.Electron microscopy revealed that the aged normoxia+ NS group had reduced mitochondrial electron density ( P<0.001)and less developed rough endoplasmic reticulum compared with the young normoxia+ NS group.The young hypoxia+ NS group exhibited a smaller mitochondrial area( P<0.001), decreased mitochondrial matrix electron density( P<0.001), blurred or absent mitochondrial cristae, inactive rough endoplasmic reticulum, and increased accumulation of glycogen and lipid droplets compared with the young normoxia+ NS group, while the young hypoxia+ PQQ group maintained mitochondrial matrix electron density comparable to the young normoxia+ NS group.The aged hypoxia+ NS group exhibited larger mitochondrial area( P=0.001), decreased mitochondrial matrix electron density( P<0.001), blurred or absent mitochondrial cristae, mitochondrial edema, increased lysosomes, and elevated cytoplasmic electron density compared with the aged normoxia+ NS group.The aged hypoxia+ PQQ group exhibited reduced mitochondrial area( P<0.001)and restored mitochondrial matrix electron density to levels comparable with the aged normoxia+ NS group.The aged normoxia+ PQQ group demonstrated increased mitochondrial matrix electron density compared with the aged normoxia+ NS group( P<0.001). Conclusions:Chronic persistent hypoxia induces hepatic functional, histological and ultrastructural damage in mice, with more pronounced effects in aged animals.PQQ provides a certain degree of protection against these injuries.

Objective:To study the relationship between adult fluoride exposure and grip strength in rural areas of China with fluorosis, as well as the roles of basal metabolic rate (BMR) and body fat percentage (BFP) in the association between fluoride exposure and grip strength.Methods:From April to May 2017, a cluster sampling method was used to conduct a questionnaire survey, physical examination, and biological sample collection on residents aged 18 - 60 in Tongxu County, Kaifeng City, Henan Province (epidemic areas of drinking-water-borne fluorosis). A total of 1 168 subjects were included in the study, including 427 males and 741 females. The fluoride ion selective electrode method and the picric acid method were used to determine the concentrations of urine fluoride and urine creatinine, and the adjusted urine fluoride concentration (CUF) was calculated. BMR and BFP were measured by a bioelectrical impendence method, and the grip strength was measured by a Jamar grip dynamometer. The relationship between CUF, BMR, BFP and grip strength were analyzed using a generalized linear model regression. The mediation effect model was used to assess the mediating effect of BMR and BFP on the association between CUF and grip strength.Results:Female grip strength decreased by 0.28 kg ( P = 0.043) for every 1.00 mg/L increment in CUF. No similar association was found between the two in males ( P = 0.744). Regardless of gender stratification, BMR was positively correlated with grip strength ( P < 0.001). For every 1.00% increase in BFP, female grip strength decreased by 0.18 kg ( P = 0.043). The mediation effect model analysis results showed that the mediation effect ratios of BMR and BFP in the association between CUF and grip strength in female were 65.1% ( P < 0.001) and 8.4% ( P = 0.111), respectively. Conclusion:Fluoride exposure is associated with changes in female grip strength, and BMR changes play a partial mediating role in the association between fluoride exposure and female grip strength.