Objective:To investigate the value of sequential ultrasound in assessing skeletal muscle and diaphragm thickness in elderly septic patients.Methods:A retrospective study was conducted.Fifty-one elderly patients with sepsis who underwent ultrasound examinations at Beijing Chaoyang Hospital from August 2021 to August 2023 were selected, including 30 males and 21 females.Ultrasound technology was used to measure the thickness of limb skeletal muscles(biceps brachii, flexor carpi radialis, quadriceps femoris, and tibialis anterior)and diaphragm, and sequential monitoring was performed at different time points(admission, the 3rd day after admission, and the 7th day after admission)to analyze the variation rules of their thickness.The correlations between the changes in muscle thickness and the severity of the disease[such as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores and the Sepsis Organ Failure Assessment(SOFA)scores], mechanical ventilation time, and length of hospital stay were analyzed.Results:Compared with those at admission, the thickness of limb skeletal muscles and diaphragm in elderly septic patients with mechanical ventilation significantly decreased with the prolongation of hospital stay( P<0.05).The degree of thickness reduction in the flexor carpi radialis and rectus femoris was positively correlated with the APACHE II score.The degree of thickness reduction in the biceps brachii was positively correlated with the SOFA score.The degree of thickness reduction in the flexor carpi radialis, rectus femoris, and diaphragm was positively correlated with both mechanical ventilation time and hospital stay( P<0.05).Correlation heatmap analysis showed that the thickness of the flexor carpi radialis was significantly correlated with hospital stay days and APACHE II score(correlation coefficients were 100.20 and 67.47, respectively), indicating that the longer the hospital stay and the more severe the condition, the more serious the atrophy of the flexor carpi radialis. Conclusions:Measuring the thickness of skeletal muscles and the diaphragm in elderly sepsis patients using ultrasound serves as an efficient and non-invasive method for assessing the disease state, predicting prognosis, and guiding clinical treatment decisions.This approach provides vital imaging-based evidence for refining diagnostic and therapeutic strategies for elderly sepsis patients, thereby promising to enhance clinical outcomes and the quality of rehabilitation for these individuals.

OBJECTIVES: To investigate the correlation of PRELID1 with gastric cancer (GC) progression, prognosis, and epithelial-mesenchymal transition (EMT) and the underlying mechanisms. METHODS: We analyzed the data of 115 patients undergoing radical gastrectomy for GC in our hospital between February, 2018 and March, 2023 to explore the correlation of PRELID1 expression level in GC tissues with tumor progression and patient prognosis. In cultured GC cells, the effects of lentivirus-mediated overexpression or interference of PRELID1 were observed on cell migration, invasion and EMT. RESULTS: Immunohistochemical staining revealed significantly higher PRELID1 expression in GC tissues (P<0.001), whose expression level was positively correlated with CEA ≥5 ng/mL (P=0.007), CA199 ≥37 U/mL (P=0.007), G_3-4 stages (P=0.001), T_3-4 stages (P=0.001), and N_2-3 stages (P=0.020). Univariate and Cox multifactorial analysis showed that high PRELID1 level was an independent risk factor affecting 5-year survival of GC patients (P=0.001). In cultured GC cells, PRELID1 overexpression obviously promoted cell proliferation, migration, invasion, and the expressions of MMP2 and MMP9, and interference of PRELID1 produced the opposite changes. PRELID1 overexpression also increased the expressions of N-cadherin and vimentin and reduced the expression of E-cadherin. Mechanistic analyses showed that up-regulation of PRELID1 increased the expression of p-PI3K, p-AKT, and p-mTOR in GC cells, whereas its interference caused the opposite changes; the application of 740 Y-P, a PI3K/AKT pathway activator, significantly enhanced the migration, invasion, and EMT of GC cells with PRELID1 knockdown. CONCLUSIONS PRELID1 is highly expressed in GC and affects prognosis of the patients, and its high expression promotes migration, invasion and epithelial mesenchymal transition of GC cells possibly by activating the PI3K/AKT/mTOR pathway.
Humans ; Stomach Neoplasms/metabolism* ; Epithelial-Mesenchymal Transition ; Prognosis ; Cell Movement ; Cell Line, Tumor ; Male ; Female ; Middle Aged ; Signal Transduction ; Neoplasm Invasiveness ; Phosphatidylinositol 3-Kinases/metabolism* ; Proto-Oncogene Proteins c-akt/metabolism*

Objective:To investigate the value of sequential ultrasound in assessing skeletal muscle and diaphragm thickness in elderly septic patients.Methods:A retrospective study was conducted.Fifty-one elderly patients with sepsis who underwent ultrasound examinations at Beijing Chaoyang Hospital from August 2021 to August 2023 were selected, including 30 males and 21 females.Ultrasound technology was used to measure the thickness of limb skeletal muscles(biceps brachii, flexor carpi radialis, quadriceps femoris, and tibialis anterior)and diaphragm, and sequential monitoring was performed at different time points(admission, the 3rd day after admission, and the 7th day after admission)to analyze the variation rules of their thickness.The correlations between the changes in muscle thickness and the severity of the disease[such as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores and the Sepsis Organ Failure Assessment(SOFA)scores], mechanical ventilation time, and length of hospital stay were analyzed.Results:Compared with those at admission, the thickness of limb skeletal muscles and diaphragm in elderly septic patients with mechanical ventilation significantly decreased with the prolongation of hospital stay( P<0.05).The degree of thickness reduction in the flexor carpi radialis and rectus femoris was positively correlated with the APACHE II score.The degree of thickness reduction in the biceps brachii was positively correlated with the SOFA score.The degree of thickness reduction in the flexor carpi radialis, rectus femoris, and diaphragm was positively correlated with both mechanical ventilation time and hospital stay( P<0.05).Correlation heatmap analysis showed that the thickness of the flexor carpi radialis was significantly correlated with hospital stay days and APACHE II score(correlation coefficients were 100.20 and 67.47, respectively), indicating that the longer the hospital stay and the more severe the condition, the more serious the atrophy of the flexor carpi radialis. Conclusions:Measuring the thickness of skeletal muscles and the diaphragm in elderly sepsis patients using ultrasound serves as an efficient and non-invasive method for assessing the disease state, predicting prognosis, and guiding clinical treatment decisions.This approach provides vital imaging-based evidence for refining diagnostic and therapeutic strategies for elderly sepsis patients, thereby promising to enhance clinical outcomes and the quality of rehabilitation for these individuals.

Objective:To investigate the correlation between pulmonary ultrasound on pulmonary consolidation and T lymphocytes,cytokines in predicting the progression of neonatal pneumonia.Methods:A total of 80 pediatric patients with pulmonary consolidation,who admitted to neonatal ward of Beijing Chao-yang Hospital and were confirmed by the first ultrasound examination on lung from February 2021 to February 2023,were divided into study group,and 50 children,who underwent physical examination during the same period,were divided into control group.The cell subsets and cytokines between two groups were compared.The study group was further divided into mitigation group and progression group according to the disease conditions of pediatric patients of study group after they received 3 d treatment.Multifactor logistic regression was adopted to analyze the correlation among the T lymphocytes,cytokines and the progression of disease.Results:The CD3+,CD8+,CD4+/CD8+cell subsets of T lymphocytes and cytokines such as IL-17-A,TNF-α and ICAM-1 of study group were significantly higher than those of control group(t=16.483,4.933,4.113,22.933,22.433,19.525,P<0.05),respectively,and the CD4+level was significantly lower than that of control group(t=7.773,P<0.05).The CD3+cell subsets and cytokine levels such as IL-17A,TNF-α and ICAM-1 of progression group were significantly higher than those of mitigation group(t=6.815,4.631,4.307,P<0.05),however the CD4+level was significantly lower than that of mitigation group(t=3.044,P<0.05).The results of the multivariate Logistic regression analysis showed that the decrease of CD3+expression,the increase of IL-17A expression and the increase of the area of pulmonary consolidation were the risk factors of the progress of neonatal pneumonia(β=-0.176,0.777,0.931,P<0.05),respectively.The results of the Pearson-correlation analysis showed that CD3+was negative correlation with the progression of neonatal pneumonia(r=-0.295,P<0.001),however,the IL-17A and the area of pulmonary consolidation showed a positive correlation with the progression of neonatal pneumonia(r=0.677,0.517,P<0.001).Conclusion:The CD3+expression,IL-17A of peripheral blood and the area of pulmonary consolidation are significantly predictive factors of pneumonia progression,and are closely related to the progression of pneumonia.

OBJECTIVE: The present study investigated how mild moxibustion treatment affects the intestinal microbiome and expression of NLRP3-related immune factors in a rat model of intestinal mucositis (IM) induced with 5-fluorouracil (5-Fu). METHODS: Forty male Sprague-Dawley rats were randomly divided into control, chemotherapy, moxibustion and probiotics groups. The IM rat model was established by intraperitoneal injection of 5-Fu. Mild moxibustion treatment and intragastric probiotic administration were provided once daily for 15 days. Tissue morphology, serum levels of inflammatory factors and the expression levels of tight junction proteins, caspase-1, gasdermin D and NLRP3 were evaluated in colon tissue, through hematoxylin and eosin staining, electron microscopy, enzyme-linked immunosorbent assay, Western blotting, quantitative real-time reverse transcription polymerase chain reaction and immunofluorescence. Gut microbiome profiling was conducted through 16S rRNA amplicon sequencing. RESULTS: Moxibustion and probiotic treatments significantly increased the expression levels of tight junction proteins, reduced cell apoptosis and the expression levels of caspase-1, gasdermin D and NLRP3; they also decreased the serum levels of tumor necrosis factor-α, interleukin (IL)-6, IL-1β and IL-18, while increasing serum levels of IL-10. Moxibustion and probiotic treatments also corrected the reduction in α-diversity and β-diversity in IM rats, greatly increased the proportion of the dominant bacterial genus Lactobacillus and reduced the abundance of the genera Roseburia and Escherichia in chemotherapy-treated rats to levels observed in healthy animals. We also found that these dominant genera were firmly correlated with the regulation of pyroptosis-associated proteins and inflammatory factors. Finally, moxibustion and probiotic treatments elicited similar effects in regulating intestinal host-microbial homeostasis and the expression of NLRP3 inflammasome-related factors. CONCLUSION Moxibustion exerts its therapeutic effect on IM by ameliorating mucosal damage and reducing inflammation. Moreover, moxibustion modulates the gut microbiota, likely via decreasing the expression levels of the NLRP3 inflammasome.

Objective To explore the diagnostic value of ESWAN in uterine fibroids by analyzing the ESWAN signal of uterine fibroid. Methods Conventional MRI and ESWAN were carried out in thirty-seven patients with uterine fibroids.The differences of ESWAN indexes between uterine fibroids and myometrium were analyzed by paired t-test.The value of ESWAN on diagnosing uterine fibroids was analyzed by receiver operating characteristic curve(ROC curve).Results The magnitude value,phase value,R2* value and T2*value of uterine fibroids were 1 661.69 ± 45.24,(0.006 7 ± 0.007 7)Hz,(26.69 ± 1.04)Hz and(34.68 ± 1.73)ms,respectively.The magnitude value,phase value,R2* value and T2* value of myometrium were 1 790.95 ± 49.04,(0.013 1 ± 0.011 8)Hz,(22.35 ± 0.84)Hz and(42.53 ± 2.16)ms.The magnitude value,phase value and T2* value of uterine fibroids were lower than those of myometrium (P=0.008,P=0.659 and P=0.002).While the R2* value of of uterine fibroids was higher than that of myometrium(P=0.001). The area under curve(AUC)of magnitude value,phase value,R2* value and T2* value were 0.604,0.553,0.666 and 0.662.Conclusion ESWAN can show the differences between uterine fibroids and myometrium ，while the ability to independently diagnose uterine fibroids was modest.

Objective To investigate the safety and effectiveness of mesh and non-mesh techniques in laparoscopic repair of large hiatal hernias (LRLHH).Methods A retrospective clinical controlled study of mesh and non-mesh techniques in LRLHH form January 2006 to August 2014 was performed.Results A total of 83 and 36 patients were recruited to mesh and non-mesh group respectively.There were no significant differences in operation time,operation bleeding volume,hospitalization time or complications between the two groups.Main symptoms were significantly improved during the postoperative long-term follow-up in both groups.The improvement of dysphagia in mesh group showed no significant difference [22.9％ (19/83) VS 12.0％ (10/83),P=0.066],however,non-mesh group showed significant difference [30.6％ (11/36) VS 5.6％ (2/36),P=0.006].Rate of dysphagia alleviation in non-mesh group was significantly higher than that in mesh group [25.0％ (9/36) VS 10.8％ (9/83),P =0.048].Mesh-related complications of esophageal erosions occurred in 5 patients (6.0％) in mesh group,including esophageal stenosis in 3 patients,esophageal-cardiac stricture in 1 patient.Recurrent hernia occurred in 1 patient (1.2％) in mesh group and 3 patients (8.3％) in non-mesh group (P =0.082).Conclusion LRLHH with mesh should be individualized.The use of mesh in LRLHH reduces the recurrence rate,but may lead to some complications.

Objective To investigate the safety and efficacy of technical modification for laparoscopic repair of giant hiatal hernias.Methods A total of 49 patients with giant hiatal hernia underwent modified laparoscopic repair by dissecting sac, closing hiatal, mesh placement and fundoplication from June 2010 to May 2014.The operation time, hospitalization time, postoperative complications, upper gastrointestinal imaging and improvement of postoperative symptoms were observed.Results The average operation time was (103.6 ±31.7) min(88-173min).The average length of post operation hospitalization was (4.2 ± 1.8) d (range,3-12d).Postoperative complication occurred in 4 patients,including pleural effusion (1 patient),respiratory failure (1 patient), difficulty in swallowing (2 patients)with complication occurrence rate being 8.2％ (4/49).No conversion or death occurred.The average time of follow-up was (28.3 ± 12.7) months (6-50 months) in 49 cases.During the follow-up, main symptoms were relieved and no recurrence was found by barium swallow.Conclusion Technical modification for laparoscopic repair of giant hiatal hernias is safe and effective.

To observe the effect and mechanism of Chinese herbs in the treatment of taeniasis.

Objective To evaluate the clinical effect of integrated traditional and western medicine in the treatment of serious ulcerative colitis. Methods Salicylate and cortical hormone were given to patients in acute phase, supplemented by oral administration of herbal medicine and retention enema of Kushenhuaihua concoction. During the period of remission, the patients were treated mainly with Jianpiling supplemented with salicylate for at least half a year. Results In 55 patients receiving conservative treatment, 35(63.6%) recovered completely, 18(32.7%) showed effective result, only 1 patient died and another showed ineffective result (1.8%). Five patients underwent surgical treatment, among them 4 were completely relieved. Long-term follow-up showed that in 67.4% of patients the symptoms were completely relieved, and in 2.3% of patients malignant degeneration occurred, 4.7% of the patients died, and 6.9% of the patients underwent operative treatment. Conclusion The effects of integrated traditional and western medicine treatment in patients with serious ulcerative colitis is superior to western medicine aloner as evidenced by a decrease in mortality and necessity of operation.