Objective To analyze the effect of laparoscopic surgery for colorectal cancer(CRC)through lateral and intermediate approaches based on enteric nerve response and nutritional status.Methods The research subjects were selected from 118 CRC patients who received treatment from February 2021 to March 2024,and their clinical data were retrospectively analyzed.They were divided into the group A(60 cases)and the group B(58 cases),with grouping based on surgical approach.Laparoscopic radical resection of CRC by the lateral approach was performed in the group A,and in the middle group,laparoscopic radical resection of CRC was performed by the middle approach.Both groups were followed up for 1 month.Postoperative indexes,gastrointestinal function recovery,intestinal nerve response and nutritional status before and 1 month after operation,surgical complications and vascular injury during follow-up were compared between the two groups.Results Compared with the group A,the group B had significantly shorter surgical time,analgesia time,hospitalization time,bowel sounds recovery time,feeding time,and anal exhaust time.Intraoperative bleeding was significantly reduced,and the number of lymph node dissection scans was significantly increased,with statistically significant differences(P<0.05).Compared with before surgery,the levels of serum vasoactive intestinal peptide(VIP),epidermal growth factor(EGF),and substance P(SP)in both groups of patients were significantly reduced 1 month after surgery,and the group B was significantly lower than the group A,with statistically significant differences(P<0.05).Compared with before surgery,the levels of serum hemoglobin(Hb),prealbumin(PAB),albumin(Alb),retinol-binding protein(RBP),transferrin(TFN)levels,and prognostic nutritional index(PNI)of both groups of patients were significantly reduced 1 month after surgery,but the group B was significantly higher than the group A,and the differences were statistically significant(P<0.05).During the follow-up period,the total incidence of surgical complications and vascular injury rate in the group B were 3.45%and 0.00%,respectively,which were lower than those in the group A(20.00%and 10.00%),and the differences were statistically significant(P<0.05).Conclusion Compared with the lateral approach,laparoscopic surgery performed through the middle approach can significantly reduce intraoperative bleeding,shorten the duration of surgery,analgesia,and hospitalization,increase lymph node dissection,and effectively promote postoperative gastrointestinal function recovery in CRC patients,improve intestinal nerve response and nutritional status,reduce vascular damage,and have high safety.

Objective To analyze the effect of laparoscopic surgery for colorectal cancer(CRC)through lateral and intermediate approaches based on enteric nerve response and nutritional status.Methods The research subjects were selected from 118 CRC patients who received treatment from February 2021 to March 2024,and their clinical data were retrospectively analyzed.They were divided into the group A(60 cases)and the group B(58 cases),with grouping based on surgical approach.Laparoscopic radical resection of CRC by the lateral approach was performed in the group A,and in the middle group,laparoscopic radical resection of CRC was performed by the middle approach.Both groups were followed up for 1 month.Postoperative indexes,gastrointestinal function recovery,intestinal nerve response and nutritional status before and 1 month after operation,surgical complications and vascular injury during follow-up were compared between the two groups.Results Compared with the group A,the group B had significantly shorter surgical time,analgesia time,hospitalization time,bowel sounds recovery time,feeding time,and anal exhaust time.Intraoperative bleeding was significantly reduced,and the number of lymph node dissection scans was significantly increased,with statistically significant differences(P<0.05).Compared with before surgery,the levels of serum vasoactive intestinal peptide(VIP),epidermal growth factor(EGF),and substance P(SP)in both groups of patients were significantly reduced 1 month after surgery,and the group B was significantly lower than the group A,with statistically significant differences(P<0.05).Compared with before surgery,the levels of serum hemoglobin(Hb),prealbumin(PAB),albumin(Alb),retinol-binding protein(RBP),transferrin(TFN)levels,and prognostic nutritional index(PNI)of both groups of patients were significantly reduced 1 month after surgery,but the group B was significantly higher than the group A,and the differences were statistically significant(P<0.05).During the follow-up period,the total incidence of surgical complications and vascular injury rate in the group B were 3.45%and 0.00%,respectively,which were lower than those in the group A(20.00%and 10.00%),and the differences were statistically significant(P<0.05).Conclusion Compared with the lateral approach,laparoscopic surgery performed through the middle approach can significantly reduce intraoperative bleeding,shorten the duration of surgery,analgesia,and hospitalization,increase lymph node dissection,and effectively promote postoperative gastrointestinal function recovery in CRC patients,improve intestinal nerve response and nutritional status,reduce vascular damage,and have high safety.

Objective:To investigate the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) combined with bedside echocardiography in diagnosis and treatment of neonatal sepsis with cardiac dysfunction.Methods:A total of 56 children diagnosed with neonatal sepsis in the Neonatal Intensive Care Unit, Liaocheng People′s Hospital from July 2016 to July 2017 were enrolled and divided into 2 groups, namely, the cardiac dysfunction group (26 cases) and the non-cardiac dysfunction group (30 cases). Children with general infection (45 cases) hospita-lized at the same period were taken as the control group.The clinical characteristics, related laboratory indexes and prognosis were compared among 3 groups.The related factors of neonatal sepsis with cardiac dysfunction were analyzed by the multivariate Logistic regression approach, and the value of related indexes in the early prediction neonatal sepsis with cardiac dysfunction was analyzed by using the receiver operating characteristic curve (ROC). Results:The onset age of sepsis patients with cardiac dysfunction [63.0 h (30.5 h, 185.6 h)] was significantly earlier than that of the patients without cardiac dysfunction [65.0 h (34.5 h, 170.6 h)] and the control group [80.0 h (45.5 h, 202.3 h)] ( P<0.05). The main primary site of the disease was the lung, which was not statistically significant among the 3 groups ( P>0.05). The NT-proBNP level and the high sensitivity-C-reactive protein (hs-CRP)/albumin (ALB) ratio in the cardiac dysfunction group [20 230.6 ng/L (15 890.0 ng/L, 35 000.0 ng/L); 0.33(0.29, 0.81)] were significantly higher than those in the control group [7 324.5 ng/L (2 426.5ng/L, 13 890.0 ng/L); 0.06(0, 0.21)] (all P<0.05). The right ventricular diameter and the Tei index of the cardiac dysfunction group [(8.74±2.42) mm; 0.52±0.03] were significantly higher than those in the control group [(8.55±1.41)mm; 0.30±0.04], while the EF of the cardiac dysfunction group [(62.61±2.56)%] was significantly lower than that in the control group [(70.03±0.35)%] (all P<0.05). The ROC curve analysis showed that NT-proBNP and the Tei index could effectively predict sepsis with cardiac dysfunction.Specifically, NT-proBNP had a cutoff value of 12 291.5 ng/L, with sensitivity of 80%, specificity of 79%, and the area under ROC curve (AUC) of 0.81.The Tei index had a cutoff value of 0.45, with sensitivity of 74%, specificity of 77%, and the AUC of 0.78. Conclusions:NT-proBNP can be used as a marker of early cardiac dysfunction.Its combination with the Tei index of bedside echocardiography can quickly diagnose cardiac dysfunction of children with sepsis, better guide clinicians in drug use, improve cardiac function of patients and enhance the treatment effect.

Objective:To investigate the significance of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the early assessment of neonatal cardiac dysfunction in sepsis.Methods:The children diagnosed with neonatal sepsis and common infection neonates admitted to the department of pediatric neonatal intensive care unit (NICU) of Liaocheng People's Hospital from January 2016 to January 2019 were enrolled. Data of clinical sign, laboratory results, bedside echocardiography and survival data were collected, and the differences of clinical indexes were compared among sepsis patients with and without cardiac dysfunction and common infection. The risk factors of sepsis with cardiac dysfunction were analyzed by multivariate Logistic regression, and the early prediction value of NT-proBNP for neonatal septic cardiac dysfunction was evaluated by the receiver operating characteristic (ROC) curve.Results:There were 112 neonates with sepsis (49 with cardiac dysfunction and 63 without cardiac dysfunction) and 67 children with common infection included in the analysis. The onset time of neonates in septic cardiac dysfunction group was significantly earlier than that of septic non-cardiac dysfunction group and common infection group [hours: 52.9 (0, 180.3) vs. 53.9 (0, 183.6), 81.0 (45.6, 202.4), both P < 0.05]. Compared with the general infection group, albumin (ALB), white blood cell count (WBC), left ventricular ejection fraction (LVEF) in septic cardiac dysfunction group significantly decreased, NT-proBNP, hypersensitive C-reactive protein (hs-CRP)/ALB, pulmonary artery systolic pressure (PASP) significantly increased, while right ventricular (RV) and Tei index significantly increased [ALB (g/L): 24.1±3.8 vs. 27.8±3.6, WBC (×10 9/L): 12.7 (3.7, 18.9) vs. 15.4 (9.9, 23.2), LVEF: 0.626±0.123 vs. 0.700±0.021, NT-proBNP (ng/L): 20 230.6 (15 890.0, 35 000.0) vs. 7 324.5 (2 426.5, 13 890.0), hs-CRP/ALB: 0.33 (0.29, 0.81) vs. 0.06 (0.00, 0.21), PASP (mmHg, 1 mmHg = 0.133 kPa): 52.25±14.12 vs. 41.07±27.73, RV (mm): 10.74±2.42 vs. 8.55±1.41, Tei index: 0.52±0.03 vs. 0.30±0.04, all P < 0.05]. NT-proBNP and Tei index in septic cardiac dysfunction group were significantly higher than those in septic non-cardiac dysfunction group [NT-proBNP (ng/L): 20 230.6 (15 890.0, 35 000.0) vs. 13 057.6 (8 946.0, 35 000.0), Tei index: 0.52±0.03 vs. 0.39±0.02, both P < 0.05], and LVEF was significantly lower than that in septic non-cardiac dysfunction group (0.626±0.123 vs. 0.671±0.086, P < 0.05). Multivariate Logistic regression analysis showed that NT-proBNP, Tei index and hs-CRP/ALB were independent risk factors for cardiac dysfunction in sepsis neonates [odds ratio ( OR) and 95% confidence interval (95% CI) were 8.73 (1.54-5.67), 1.97 (1.26-2.87), 1.87 (1.03-3.40) respectively, all P < 0.05]. ROC curve analysis showed that NT-proBNP, Tei index and hs-CRP/ALB had good predictive value for the occurrence of cardiac dysfunction in septic neonates, the area under ROC curve (AUC) was 0.81 (95% CI was 0.84-0.91), 0.78 (95% CI was 0.65-0.79) and 0.77 (95% CI was 0.61-0.77), respectively. The sensitivity and specificity of NT-proBNP were 80.0% and 79.0% respectively with 12 291.5 ng/L as the cut-off value, the sensitivity and specificity of Tei index were 74.0% and 77.0% respectively with 0.45 as the cut-off value, and the sensitivity and specificity of hs-CRP/ALB were 76.0% and 76.3% respectively with 0.10 as the cut-off value. Conclusions:NT-proBNP can be used as a diagnostic marker of early cardiac dysfunction, and for rapid diagnosis of neonatal cardiac dysfunction in sepsis. The application may guide clinicians to use drugs better to improve cardiac function and treatment effect.

Objective: To search for biomarkers for human familial prion disease. Methods: Two-dimensional differential gel electrophoresis (2D-DIGE) proteomic analysis has been performed in frontal lobe tissues of 3 patients suffering from human familial prion disease (PrP) and 3 age-and sex-matched patients suffering from sudden death due to heart failure without neurological disease. Results: The maps revealed 14 polypeptide chains differentially modulated in the PrP samples, among those, 7 could be identified upon digestion and MALDI-TOF/MS analysis, of which 6 appeared to be up-regulated, 1 being down-regulated. Conclusions We highlight Galectin-1(Gal-1), ryanodine receptor 2 (RyR2), ubiquitin, Rab-interacting lysosomes protein-like protein 1 (RILPL-1) profillin 2 (PFN2), in the differential map. These proteins are related to neurogenesis, the clearance of misfolded proteins, stasis of calium channel, myoclonus and so on. These proteins are potential biomarkers or targets for treatment of prion disease.

Objective To investigate the clinical application value of ductoscopic flushing in the treatment of early lactation acute mastitis.Methods 52 patients with early acute mammitis were divided into observation group (27 cases)and control group(25 cases)according to the principle of completely random.In the observation group, the patients were checked under the intervention of mammary duct firstly,and then the disease regions of the breast were flushed using ductoscope.In the control group,the patients were treated with artificial breast -milk.The two groups were all treated with the same antibiotics.The curative effect of the two groups was observed,and the statistical analysis was performed.Results In the observation group,the mass extinction time,pain relief time,pyretolysis time, hemogram recovery time,contralateral continued breast -feeding proportion,the proportion of abscess formation,the proportion of back -milk,the proportion of ipsilateral quadrant recurrence were (3.5 ±1.2)h,(5.0 ±0.9)h, (1.0 ±0.1)d,(1.0 ±0.3)d,92.6%,7.4%,7.4%,0.0% respectively,those in the control group were (24.0 ± 3.2)h,(2.0 ±2.1)h,(2.0 ±0.2)d,(3.0 ±0.3)d,88.0%,12.0%,12.0%,8.0% respectively.The differences between the two groups were statistically significant(t =1.72,0.36,0.43,0.72,χ2 =1.83,2.02,1.56,0.34,all P <0.05).Conclusion Ductoscopic flushing has good effect in the treatment of early lactation acute mastitis,and it is worthy of clinical promotion.

OBJECTIVEFatal familial insomnia (FFI) is an autosomal dominant prion disease characterized clinically by inattention, sleep loss, dysautonomia, and motor signs. This study is aimed to investigate clinical and familial characteristics of ten Chinese Patients with FFI.

METHODSWe identified ten FFI cases from the surveillance network for Creutafeldt-Jakob disease (CJD) in China. Final diagnosis of FFI cases was made in accordance with the WHO criteria for CJD. The main clinical features and family histories of these ten FFI cases were analyzed.

RESULTSThe median age of ten cases at onset was 38 years (from 19 to 55). The foremost symptoms seemed to be various, including sleep disturbances, vision disorder, dizziness and anorexia. Sleep disturbances appeared in all cases and lasted in the whole clinical courses. Progressive sympathetic symptoms, memory loss, movement disturbances, myoclonus and hypertension were also frequently observed. The median duration of the disease was 9.5 months. EEG and MRI did not figure out special abnormality. 14-3-3 protein in CSF was positive in five out of eight tested patients. Clear family histories were identified in 8 patients.

CONCLUSIONThe data from our study confirm that the Chinese FFI cases have similar clinical characteristics as that of the Caucasian cases. Compared with other genetic CJD associated mutations, the genetic frequencies of D178N in PRNP are apparently high among the Chinese cases.

Adult ; Asian Continental Ancestry Group ; Female ; Humans ; Insomnia, Fatal Familial ; pathology ; physiopathology ; Male ; Middle Aged ; Young Adult

OBJECTIVETo break immune tolerance to prion (PrP) proteins using DNA vaccines.

METHODSFour different human prion DNA vaccine candidates were constructed based on the pcDNA3.1 vector: PrP-WT expressing wild-type PrP, Ubiq-PrP expressing PrP fused to ubiquitin, PrP-LII expressing PrP fused to the lysosomal integral membrane protein type II lysosome-targeting signal, and PrP-ER expressing PrP locating the ER. Using a prime-boost strategy, three-doses of DNA vaccine were injected intramuscularly into Balb/c mice, followed by two doses of PrP protein. Two weeks after the last immunization, sera and spleens were collected and PrP-specific humoral and cellular immune responses evaluated by ELISA and ELISPOT tests.

RESULTSHigher levels of serum PrP antibodies were detected in mice vaccinated using the strategy of DNA priming followed by protein boosting. Of these, WT-PrP, Ubiq-PrP, and PrP-LII induced significantly higher humoral responses. ELISPOT tests showed markedly increased numbers of IFN-γ-secreting T cells in mice vaccinated using the strategy of DNA priming followed by protein boosting after stimulation with recombinant PrP23-90 and PrP23-231. PrP-ER induced the strongest T-cell response.

CONCLUSIONPrion vaccines can break tolerance to PrP proteins and induce PrP-specific humoral and cellular immune responses.

Animals ; Antibodies ; immunology ; CHO Cells ; COS Cells ; Cercopithecus aethiops ; Cricetinae ; Cricetulus ; Enzyme-Linked Immunosorbent Assay ; Female ; HeLa Cells ; Humans ; Immune Tolerance ; Interferon-gamma ; immunology ; Lysosomal-Associated Membrane Protein 2 ; genetics ; immunology ; Mice ; Mice, Inbred BALB C ; Peptide Fragments ; immunology ; Prions ; genetics ; immunology ; Receptors, Peptide ; genetics ; immunology ; Recombinant Fusion Proteins ; genetics ; immunology ; Recombinant Proteins ; immunology ; Transfection ; Ubiquitin ; genetics ; immunology ; Vaccines, DNA