Objective:To investigate the association between abdominal fat-related indicators derived from quantitative computed tomography (QCT) and coronary artery calcification (CAC) in middle-aged and elderly individuals, as well as the diagnostic value of these indicators.Methods:This cross-sectional study enrolled middle-aged and elderly participants who underwent health check-ups at Kaifeng Central Hospital between January and December 2024. Participants were divided into a CAC group and a non-CAC group based on the presence or absence of CAC. The CAC group was then stratified into mild, moderate, and severe subgroups according to CAC severity. General clinical data were collected for all participants. All subjects underwent one-stop QCT scanning of the chest and abdomen. An automated abdominal fat analysis system was used to identify fat distribution regions. If accurate identification was not possible, a semi-automated segmentation algorithm combined with manual correction was applied instead. Two physicians performed the measurements independently, and inter-observer consistency was assessed. The average values were calculated to obtain visceral fat area (VFA) and subcutaneous fat area (SFA). The ratio of visceral fat area to subcutaneous fat area (VFA/SFA) was also computed. Multivariate logistic regression analysis was performed to identify the factors associated with CAC in middle-aged and elderly individuals. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of these indicators for CAC. DeLong′s test was used to compare the differences in the area under the curve ( AUC). Results:A total of 252 middle-aged and elderly individuals were included, with a median age of 61 (interquartile rang: 59, 69) years. Of these individuals, 188(74.6%) were males. Among them, 172 were classified into the CAC group and 80 into the non-CAC group. Multivariate logistic regression analysis revealed that VFA, VFA/SFA ratio, age, low-density lipoprotein cholesterol(LDL-C), and hypertension were independently associated with CAC in middle-aged and elderly individuals (all P<0.05). The mild, moderate, and severe CAC subgroups comprised 78, 51, and 43 participants, respectively. Analysis of variance (ANOVA) demonstrated that VFA and VFA/SFA increased with CAC severity, and there were statistically significant differences between the subgroups (all P<0.05). ROC curve analysis showed that the AUCs of VFA and VFA/SFA for diagnosing CAC were 0.841 and 0.810, respectively, with no significant difference between them ( P>0.05). The optimal cutoff values were 177.45 cm2 for VFA (sensitivity: 83.1%, specificity: 72.5%) and 1.592 for VFA/SFA (sensitivity: 65.7%, specificity: 83.7%). For the diagnosis of moderate-to-severe CAC, the AUCs of VFA and VFA/SFA were 0.765 and 0.761, respectively ( P>0.05 for comparison), with cutoff values of 231.75 cm2 (sensitivity: 61.7%, specificity: 83.3%) and 1.962 (sensitivity: 64.9%, specificity: 80.8%). Conclusion:Abdominal VFA and VFA/SFA derived from QCT are independently associated with the presence of CAC in middle-aged and elderly individuals, demonstrating good diagnostic performance for both overall CAC and moderate-to-severe CAC.

Objective:To explore the efficacy and safety of ultrasound-guided radiofrequency ablation for liver metastasis combined with laparoscopic resection of colorectal cancer in the treatment of colorectal cancer liver metastasis (CRLM).Methods:A retrospective cohort study was conducted. Sixty-five CRLM patients who were admitted to Shanxi Province Cancer Hospital from July 2018 to July 2020 were collected and divided into two groups based on different surgical methods: the ultrasound-guided radiofrequency ablation treatment for liver metastasis combined with laparoscopic colorectal cancer resection group (study group) and the total laparoscopic surgery group (control group), with 26 and 39 cases, respectively. The postoperative hospitalization time, surgical cost, intraoperative blood loss, postoperative anal exhaust or defecation time, postoperative feeding time, incidence of postoperative complications, postoperative recurrence and survival status were compared between the two groups of patients.Results:There was no statistically significant difference in age, gender, type of colorectal cancer, number of liver metastasis, and maximum diameter of liver metastasis between the two groups of patients (all P > 0.05). The study group and the control group showed statistically significant differences in postoperative hospitalization time [(5.4±2.2) d vs. (7.0±2.5) d], surgical costs [(4.7±0.8) ten thousand yuan vs. (3.9±0.6) ten thousand yuan], intraoperative blood loss [(104±11) ml vs. (187±20) ml], postoperative anal exhaust or defecation time [(2.2±1.5) d vs. (3.5±1.3) d], and postoperative feeding time [(2.4±1.6) d vs. (3.8±1.2) d] ( t values were 2.82, 4.63, 21.95, 3.57, and 3.65, respectively, all P < 0.01). There was no statistically significant difference in the incidence of subphrenic infection, incision infection, bile leakage, postoperative wound bleeding, liver failure, postoperative 3-year recurrence rate, and postoperative 1-, 2- and 3-year survival rates between the study group and the control group (all P > 0.05). Conclusions:The effect of ultrasound-guided radiofrequency ablation for liver metastasis combined with laparoscopic resection of colorectal cancer for CRLM is comparable to that of total laparoscopic surgery, and the hospitalization time, exhaust or defecation time and feeding time are shortened, the intraoperative bleeding is less, and the surgical complications are not increased.

Objective:To investigate the association between abdominal fat-related indicators derived from quantitative computed tomography (QCT) and coronary artery calcification (CAC) in middle-aged and elderly individuals, as well as the diagnostic value of these indicators.Methods:This cross-sectional study enrolled middle-aged and elderly participants who underwent health check-ups at Kaifeng Central Hospital between January and December 2024. Participants were divided into a CAC group and a non-CAC group based on the presence or absence of CAC. The CAC group was then stratified into mild, moderate, and severe subgroups according to CAC severity. General clinical data were collected for all participants. All subjects underwent one-stop QCT scanning of the chest and abdomen. An automated abdominal fat analysis system was used to identify fat distribution regions. If accurate identification was not possible, a semi-automated segmentation algorithm combined with manual correction was applied instead. Two physicians performed the measurements independently, and inter-observer consistency was assessed. The average values were calculated to obtain visceral fat area (VFA) and subcutaneous fat area (SFA). The ratio of visceral fat area to subcutaneous fat area (VFA/SFA) was also computed. Multivariate logistic regression analysis was performed to identify the factors associated with CAC in middle-aged and elderly individuals. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of these indicators for CAC. DeLong′s test was used to compare the differences in the area under the curve ( AUC). Results:A total of 252 middle-aged and elderly individuals were included, with a median age of 61 (interquartile rang: 59, 69) years. Of these individuals, 188(74.6%) were males. Among them, 172 were classified into the CAC group and 80 into the non-CAC group. Multivariate logistic regression analysis revealed that VFA, VFA/SFA ratio, age, low-density lipoprotein cholesterol(LDL-C), and hypertension were independently associated with CAC in middle-aged and elderly individuals (all P<0.05). The mild, moderate, and severe CAC subgroups comprised 78, 51, and 43 participants, respectively. Analysis of variance (ANOVA) demonstrated that VFA and VFA/SFA increased with CAC severity, and there were statistically significant differences between the subgroups (all P<0.05). ROC curve analysis showed that the AUCs of VFA and VFA/SFA for diagnosing CAC were 0.841 and 0.810, respectively, with no significant difference between them ( P>0.05). The optimal cutoff values were 177.45 cm2 for VFA (sensitivity: 83.1%, specificity: 72.5%) and 1.592 for VFA/SFA (sensitivity: 65.7%, specificity: 83.7%). For the diagnosis of moderate-to-severe CAC, the AUCs of VFA and VFA/SFA were 0.765 and 0.761, respectively ( P>0.05 for comparison), with cutoff values of 231.75 cm2 (sensitivity: 61.7%, specificity: 83.3%) and 1.962 (sensitivity: 64.9%, specificity: 80.8%). Conclusion:Abdominal VFA and VFA/SFA derived from QCT are independently associated with the presence of CAC in middle-aged and elderly individuals, demonstrating good diagnostic performance for both overall CAC and moderate-to-severe CAC.

Objective:To explore the efficacy and safety of ultrasound-guided radiofrequency ablation for liver metastasis combined with laparoscopic resection of colorectal cancer in the treatment of colorectal cancer liver metastasis (CRLM).Methods:A retrospective cohort study was conducted. Sixty-five CRLM patients who were admitted to Shanxi Province Cancer Hospital from July 2018 to July 2020 were collected and divided into two groups based on different surgical methods: the ultrasound-guided radiofrequency ablation treatment for liver metastasis combined with laparoscopic colorectal cancer resection group (study group) and the total laparoscopic surgery group (control group), with 26 and 39 cases, respectively. The postoperative hospitalization time, surgical cost, intraoperative blood loss, postoperative anal exhaust or defecation time, postoperative feeding time, incidence of postoperative complications, postoperative recurrence and survival status were compared between the two groups of patients.Results:There was no statistically significant difference in age, gender, type of colorectal cancer, number of liver metastasis, and maximum diameter of liver metastasis between the two groups of patients (all P > 0.05). The study group and the control group showed statistically significant differences in postoperative hospitalization time [(5.4±2.2) d vs. (7.0±2.5) d], surgical costs [(4.7±0.8) ten thousand yuan vs. (3.9±0.6) ten thousand yuan], intraoperative blood loss [(104±11) ml vs. (187±20) ml], postoperative anal exhaust or defecation time [(2.2±1.5) d vs. (3.5±1.3) d], and postoperative feeding time [(2.4±1.6) d vs. (3.8±1.2) d] ( t values were 2.82, 4.63, 21.95, 3.57, and 3.65, respectively, all P < 0.01). There was no statistically significant difference in the incidence of subphrenic infection, incision infection, bile leakage, postoperative wound bleeding, liver failure, postoperative 3-year recurrence rate, and postoperative 1-, 2- and 3-year survival rates between the study group and the control group (all P > 0.05). Conclusions:The effect of ultrasound-guided radiofrequency ablation for liver metastasis combined with laparoscopic resection of colorectal cancer for CRLM is comparable to that of total laparoscopic surgery, and the hospitalization time, exhaust or defecation time and feeding time are shortened, the intraoperative bleeding is less, and the surgical complications are not increased.

Objective:To learn about the single nucleotide polymorphism (SNP) population structure and regional distribution characteristics of Yersinia pestis in the natural focus of plague in Qinghai-Tibet Plateau. Methods:A total of 319 representative strains of Yersinia pestis isolated from natural focus of plague in Qinghai-Tibet Plateau from 1954 to 2020 were selected, and 2 298 SNP loci included in the global Yersinia pestis phylogenetic tree were compared by whole genome sequencing technology. MEGA 6.0 software was used to construct phylogenetic trees of 319 strains of Yersinia pestis from Qinghai-Tibet Plateau, determine the SNP population structure of Yersinia pestis in the focus, and describe its regional distribution characteristics. Results:The 319 strains of Yersinia pestis isolated from Qinghai-Tibet Plateau natural plague foci were distributed in 5 clades, namely 1.IN, 2.ANT, 3.ANT, 0.PE and 2.MED. The 1.IN clade contained 209 strains (65.52%, 209/319), which was the dominant population of strains in Qinghai Province, accounting for 90.51% (143/158). The 2.ANT clade contained 83 strains (26.02%, 83/319), which was the dominant population in Tibet Autonomous Region, accounting for 67.24% (78/116). The 3.ANT, 0.PE, and 2.MED clades contained 12 (3.76%, 12/319), 9 (2.82%, 9/319) and 6 strains (1.88%, 6/319), respectively, which were scattered in Qinghai Province, Gansu Province, Sichuan Province, Tibet Autonomous Region, and Xinjiang Uygur Autonomous Region under the jurisdiction of Qinghai-Tibet Plateau. Conclusion:The SNP population structure of Yersinia pestis in natural focus of plague in Qinghai-Tibet Plateau is relatively rich, and the strains are distributed in 5 clades: 1.IN, 2.ANT, 3.ANT, 0.PE and 2.MED, showing the distribution characteristics of specific regions.

ObjectiveTo analyze the effects of polydatin on myeloma cell growth，apoptosis， and reactive oxygen species（ROS）/p38 mitogen-activated protein kinase（MAPK） signaling pathway. MethodHuman multiple myeloma （MM） cell line U266 cells were cultured in vitro，and the effects of polydatin at 0，20，40，80，160，200 mg·L^-1 on the growth of U266 cells were detected by cell counting kit-8（CCK-8）assay. The half-maximal inhibitory concentration（IC₅₀）was calculated. U266 cells in the logarithmic growth phase were randomly divided into a control group， low- and high-dose polydatin （80 and 160 mg·L^-1） groups， and a bortezomib （75 nmol·L^-1） group. After treatment with corresponding drugs，the cell viability of each group was determined by CCK-8 assay. The apoptosis rate of each group was measured by flow cytometry. The levels of inflammatory factors， such as tumor necrosis factor-α（TNF-α），interleukin-1β（IL-1β）， and ROS in each group were measured by enzyme-linked immunosorbent assay （ELISA）. The protein expression levels of apoptosis-related factors， including cysteine aspartate-specific protease-9（Caspase-9），B-cell lymphoma-2-associated X protein（Bax），p38 MAPK，and phosphorylated （p）-p38 MAPK in each group were detected by Western blot. ResultCompared with the results in the control group， polydatin of different concentrations could inhibit the growth of U266 cells （P<0.05），and the effect was potentiated with the increase in the concentration，with IC₅₀ of 156.54 mg·L^-1. Compared with the control group，the groups with drug treatment showed blunted cell viability （P<0.05） and increased apoptosis rate，TNF-α，IL-1β，and ROS levels， protein expression levels of Caspase-9， Bax，and p-p38 MAPK/p38 MAPK （P<0.05）. Compared with the low-dose polydatin group， the high-dose polydatin group and the bortezomib group showed improved indicators mentioned above （P<0.05）， and there was no significant difference between the high-dose polydatin group and the bortezomib group. ConclusionPolydatin can activate the ROS/p38 MAPK signaling pathway，promote the expression of inflammatory factors，inhibit the growth of U266 cells，and promote their apoptosis.

Objective:To explore the correlation of the dose of capecitabine with the efficacy and cardiotoxicity in patient-derived tumor xenograft (PDX) model of mice with colorectal cancer.Methods:The fresh cancer tissues of 1 colorectal cancer patient were transplanted into the bilateral axillary subcutaneous of immunodeficient NOG mice to establish PDX model and passage stably. And then the morphology of tumor cells in primary generation and the second-generation tumor tissues was observed by using HE staining. The expression of tumor markers was detected by using immunohistochemistry method, and the model was evaluated. Mice were intragastrically infused with 200, 300 and 400 mg/kg capecitabine once a day, which were treated as low, middle and high dose groups respectively, 5 rats in each group; in the control group, 0.9% NaCl solution was perfused into the stomach; 14 d in total, use stop for 7 d, consecutively administered in this way. The body weight was measured every day and the tumor volume was measured every 3 days. After 100 days of observation, the mice were killed, and the tumor tissue was taken to measure the tumor weight and then the tumor volume, tumor volume inhibition rate and tumor inhibition rate were calculated. The morphology of tumor tissues was observed by using HE staining. The protein levels of anti-tumor effect indexes like rasP21, cyclooxygenase 2 (COX2), prostaglandin E2 (PGE2), cardiac troponin Ⅰ (cTn-Ⅰ) and brain natriuretic peptide (BNP) in serum of mice were detected by using enzyme linked immunosorbent assay (ELISA).Results:PDX model of mice with colorectal cancer was successfully constructed, and the histological characteristics of the primary tumor in the model were well preserved. During administration, 1 mouse died in the capecitabine high dose group; a slow down in tumor volume growth could be found with the increased dose of capecitabine. There was no statistically significant difference in body weight among 4 groups until all mice were killed ( P > 0.05). The tumor volume and tumor weight in the low, middle and high dose groups were lower than those in the control group (all P < 0.05), and the tumor volume and tumor weight showed an obvious decrease with the increase in dose. The tumor volume inhibition rates of low, middle and high dose groups were 42.61%, 67.61% and 77.27%, respectively, and the tumor inhibition rates were 35.53%, 67.77% and 75.09%, respectively. The serum anti-tumor effect indexes rasP21, COX2 and PGE2 in the middle and high dose groups were decreased compared with those in the control group (all P < 0.05), while cTn-Ⅰ and BNP levels were increased compared with those in the control group (all P < 0.05). Conclusions:The established PDX model of mice with colorectal cancer can better retain the histological characteristics of the original tumor. After treatment of middle and high dose of capecitabine, the tumor inhibition effect is obvious, but the risk of myocardial damage should be noticed.

Objective:To explore the survival status of rectal cancer patients with liver metastasis after receiving different treatments and its influencing factors.Methods:The clinicopathological characteristics, treatment methods and survival of 211 rectal cancer patients with liver metastasis who received different treatments in Shanxi Provincial Cancer Hospital from January 2012 to December 2016 were retrospectively analyzed. Cox proportional hazards regression model was used to analyze the related factors affecting the prognosis of patients.Results:The median overall survival (OS) time of 211 rectal cancer patients with liver metastasis was 19 months (1-115 months), and the 1-, 3- and 5-year OS rates were 66%, 22% and 10%. The OS of rectal cancer patients with metachronous liver metastasis was better than that of rectal cancer patients with simultaneous liver metastasis ( χ2 = 17.225, P < 0.01). The OS of patients with primary tumor resection was better than that of patients without primary tumor resection ( χ2 = 69.54, P < 0.01). Among patients with primary tumor resection, the OS of patients with untreated liver metastasis was worse than that of patients with interventional treatment of liver metastasis ( χ2 = 7.311, P = 0.007). Among the patients without primary tumor resection, the OS of patients with chemotherapy alone was better than that of untreated patients ( χ2 = 4.123, P = 0.042). The OS of patients with primary tumor resection and untreated liver metastasis and patients with primary tumor resection and liver metastasis intervention therapy was better than that of patients with chemotherapy alone (both P < 0.01). The results of Cox regression analysis showed that the differentiation degree of primary tumor, liver metastasis and carbohydrate antigen 199 level at diagnosis were independent factors influencing the survival of rectal cancer patients with liver metastasis (all P < 0.01). Conclusion:For patients with diagnosed rectal cancer, even if there is liver metastasis before surgery, active surgical resection of the primary tumor and local treatment of liver metastasis can still improve the survival.

Objective:To explore the association between statins and colorectal cancer and provide evidence for the prevention of colorectal cancer.Methods:Literatures about statins and colorectal cancer published from January 2000 to January 2020 were retrieved from CNKI, Wanfang data, PubMed and Cochrane Library database. The literatures which met the inclusion criteria were collected, and the Newcastle-Ottawa Scale and Jadad score were used to assess the studies. Meta-analysis was performed with statistical software Revman 5.0 and Stata 12.1.Results:A total of 31 studies, involving more than 1.62 million subjects, were included in the analysis. The case-control study ( RR=0.93, 95% CI: 0.88-0.98), the cohort study ( RR=0.75, 95% CI: 0.63-0.88) and the randomized controlled trial ( RR=0.79, 95% CI: 0.65-0.97) showed moderate protective effect of statins. Using statin <5 years ( RR=0.86, 95% CI: 0.76-0.96), average daily dosage ≥34 mg ( RR=0.81, 95% CI: 0.66-0.98) and lipid-soluble statins ( RR=0.86, 95% CI: 0.74-0.99) also had preventive effect on colorectal cancer; while lovastatin ( RR=1.07, 95% CI: 1.00-1.14) increased the risk of colorectal cancer. Conclusion:Statins have protective effect on colorectal cancer.

Objective:To analyze the expression of miR-30a-5p and miR-211 in colorectal cancer tissues, and to explore the relationships between the expression of miR-30a-5p, miR-211 and the clinicopathological characteristics, prognosis of colorectal cancer.Methods:80 patients with colorectal cancer treated in our hospital from February 2013 to December 2015 were retrospectively analyzed, and colorectal cancer tissues and corresponding adjacent tissues (≥3 cm far from the lesion) were collected during operation. Real-time fluorescence quantitative analysis (qRT-PCR) was used to detect the expression levels of miR-30a-5p and miR-211 in tissues, and the relationships between the expressions of miR-30a-5p, miR-211 and the clinicopathological characteristics, prognosis of colorectal cancer patients were analyzed.Results:The expression levels of miR-30a-5p and miR-122 in colorectal cancer tissues were significantly lower than those in adjacent tissues ( P<0.05). The expression levels of miR-30a-5p and miR-211 were not related to gender, age and location of tumors ( P>0.05), but related to differentiation, size of tumors, degree of invasion, tumor node metastasis (TNM) stage and lymph node metastasis ( P<0.05). There was a positive correlation between the expressions of miR-30a-5p and miR-211 in colorectal cancer ( r=0.337, P<0.05). The 3-year survival rates of the low-expression groups of miR-30a-5p and miR-211 were significantly lower than those of the high-expression groups of miR-30a-5p and miR-211 (all P<0.05). Low differentiation, high TNM stage, lymph node metastasis, low expression of miR-30a-5p and low expression of miR-211 were independent risk factors for poor prognosis of colorectal cancer patients ( P<0.05). Conclusions:The expressions of miR-30a-5p and miR-211 are low in colorectal cancer tissues, both of them are related to the clinicopathological characteristics and prognosis of colorectal cancer, such as the degree of differentiation of tumors, lymph node metastasis and so on, which may play a common role in influencing the occurrence and development of colorectal cancer.