Objective To retrospectively analyse the clinical characteristics of complex anal fistula and the distribution of TCM syndrome in infants and young children.Methods The clinical data of 118 children with complex anal fistula who were hospitalised in the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine from 1 January 2019 to 1 January 2023 were retrospectively analysed for gender,age,fistula,internal and external orifices,and distribution of TCM syndrome.Results Totally 115 cases(97.5%)were male and 3 cases(2.5%)were female among the 118 cases,with statistically significant differences(P<0.05);they occurred within 1 year of age;among them,there were 93 cases(78.8%)of low complex anal fistula,and 25 cases(21.2%)of high complex anal fistula;there were 2 fistulas(76.3%),followed by 3 fistulas(21.2%)and 4 fistulas(2.5%);the relationship between the number of internal and external orifices was dominated by external orifices = internal orifices(71.2%),and the internal and external orifices were mostly located at the 3 and 9 points(truncation);dampness-heat pouring downward was the most common syndrome(58.5%),followed by foetal toxin(23.7%),and spleen deficiency and dampness(17.8%).Conclusion Complex anal fistula in infants and young children occurred in male children less than 1 year old,and most of them were low complex anal fistula with two fistulas,and the internal and external orifices were mostly distributed in the 3 and 9 points(truncation),and dampness-heat pouring downward was the main TCM syndrome.

Objective:To explore the prevalence and risk factors of sarcopenia in patients with maintenance dialysis (MHD).Methods:It was a cross-sectional study. Patients who received MHD treatment in the Blood Purification Center of Hainan Provincial People's Hospital in October 2019 were included as study subjects. The patients were divided into sarcopenia group and non-sarcopenia group according to whether they had sarcopenia or not. Chest CT imaging and laboratory examination data were collected. Dual-energy X-ray absorptiometry was used to measure the skeletal muscle mass. Chi-square test or Mantel-Haenszel trend chi-square test was used to compare the clinical data of patients with and without sarcopenia. Multivariate logistic regression equation was used to analyze the risk factors of sarcopenia.Results:A total of 182 MHD patients were enrolled in the study, and the prevalence of sarcopenia was 33.5% (61/182). The proportions of age ≥60 years old, diabetic nephropathy, tunneled-cuffed catheter, body mass index <18 kg/m 2, serum albumin <40 g/L, low density lipoprotein cholesterol ≥3.37 mmol/L, left ventricular ejection fraction <50%, chest CT-suspected pulmonary tuberculosis (PTB) and PTB in sarcopenia group were higher than those in non-sarcopenia group (all P<0.05). Multivariate logistic regression analysis results showed that left ventricular ejection fraction <50% (≥50% as a reference, OR=3.250, 95% CI 1.035-10.206, P=0.044), low-density lipoprotein cholesterol ≥3.37 mmol/L (<3.37 mmol/L as a reference, OR=6.354 ,95% CI 1.675-24.108, P=0.007), chest CT-suspected PTB (normal as a reference, OR=7.433, 95% CI 1.531-36.083, P=0.013), and PTB (normal as a reference, OR=28.871, 95% CI 3.208-259.872, P=0.030) were independent influencing factors of sarcopenia in MHD patients. Conclusions:The prevalence of sarcopenia is higher in MHD patients. Blood low-density lipoprotein cholesterol ≥3.37 mmol/L, ejection fraction <50%, chest CT-PTB and suspected PTB are independent risk factors of sarcopenia in MHD patients. Correcting left ventricular systolic function, regulating blood lipids and preventing PTB as early as possible can reduce the prevalence of sarcopenia in MHD patients.

Objective:To explore the effect of applying the multi-disciplinary team（MDT）model led by specialized nursing care in the treatment carried out at early stage in intensive care unit of hyperbaric oxygen（ICU-HBO）for patients with brain complications after Stanford type A aortic dissection（AD）surgery.Method:From January 2018 to December 2020，a total of 18 patients with brain complications after AD surgery were included and treated by ICU-HBO with MDT model. The patients’ ventilator tolerance and weaning time，outcome，occurrence of adverse events，and satisfaction rate of nursing care were observed.Results:（1）Fifteen mechanically ventilated patients were successfully weaned off the machine after 1-5 times of ICU-HBO treatment.（2）Sixteen patients regained their consciousness to the normal level after 2-13 times of ICU-HBO treatments，with the total effective rate of 88.89%；two patients in persistent vegetative state（deep coma）discontinued the treatment after two times of ICU-HBO treatments as their family gave up. During the follow-up period of six months to two years，11 cases were found clinically cured，one case was considered effective，four cases lost contact，and the two cases that had gave up treatment died of complications.（3）No adverse medical event（related to safety）occurred during the ICU-HBO treatment.（4）The satisfaction rate of nursing care was 100%.Conclusion:In the early ICU-HBO treatment of patients with brain complications after Stanford type A AD surgery，the application of MDT mode led by specialized nursing care is beneficial to the treatment risk control，ensure the treatment effectiveness，and improve the long-term prognosis，and quality of life of AD patients.

Objective:To explore the effect of applying the multi-disciplinary team（MDT）model led by specialized nursing care in the treatment carried out at early stage in intensive care unit of hyperbaric oxygen（ICU-HBO）for patients with brain complications after Stanford type A aortic dissection（AD）surgery.Method:From January 2018 to December 2020，a total of 18 patients with brain complications after AD surgery were included and treated by ICU-HBO with MDT model. The patients’ ventilator tolerance and weaning time，outcome，occurrence of adverse events，and satisfaction rate of nursing care were observed.Results:（1）Fifteen mechanically ventilated patients were successfully weaned off the machine after 1-5 times of ICU-HBO treatment.（2）Sixteen patients regained their consciousness to the normal level after 2-13 times of ICU-HBO treatments，with the total effective rate of 88.89%；two patients in persistent vegetative state（deep coma）discontinued the treatment after two times of ICU-HBO treatments as their family gave up. During the follow-up period of six months to two years，11 cases were found clinically cured，one case was considered effective，four cases lost contact，and the two cases that had gave up treatment died of complications.（3）No adverse medical event（related to safety）occurred during the ICU-HBO treatment.（4）The satisfaction rate of nursing care was 100%.Conclusion:In the early ICU-HBO treatment of patients with brain complications after Stanford type A AD surgery，the application of MDT mode led by specialized nursing care is beneficial to the treatment risk control，ensure the treatment effectiveness，and improve the long-term prognosis，and quality of life of AD patients.

Objective:To observe the clinical efficacy of Heweishupiyin decoction in the treatment of functional dyspepsia (FD) in elderly patients with liver stagnation and spleen deficiency.Methods:A randomized controlled method was performed in this study, and 70 FD patients were selected from February 2018 to June 2019 in accordance with the inclusion criteria.The patients were divided into the observation group and the control group according to the random digital table method, with 35 cases in each group.The observation group was treated with Heweishupiyin decoction, the control group was given mosapride citrate tablets.The period of treatment was 4 weeks.The changes of total symptom scores, TCM syndrome evaluation, electrogastrogram (EGG) parameters, serum serotonin, and Hamilton depression scale (HAMD) scores before and after treatment were recorded.The statistical analysis was performed to evaluate the clinical efficacy of Heweishupiyin decoction.Results:After treatment, the overall symptom scores in both two groups were decreased.The overall symptom score of the observation group after treatment[(8.03±4.23)points] was lower than that of the control group[(10.36±4.67)points], and the difference was statistically significant( t=2.145, P<0.05). The overall efficacy of TCM symptoms of the observation group was 88.2% (30/35), which was significantly higher than 72.8% (24/35) of the control group ( Z=-2.473, P<0.05). After treatment, the EGG parameters of two groups had different degrees of increase, the main frequency of the observation group after meal[(3.39±0.34)cpm] was higher than that of the control group[(3.18±0.36)cpm], the difference was statistically significant( t=-2.202, P<0.05). The percentage of normal slow wave in the observation group[(68.91±4.79)%] was higher than that in the control group[(66.33±3.00)%], and the difference was statistically significant( t=-2.549, P<0.05). The reaction area of the observation group[(99.09±13.58)μV/s] was higher than that of the control group[(90.27±14.70)μV/s], and the difference was statistically significant( t=-2.390, P<0.05). After 4 weeks of treatment, the HAMD score of the observation group[(14.94±2.42)points] was lower than that of the control group[(16.94±4.29)points], and the difference was statistically significant( t=2.355, P<0.05). The serum level of serotonin after treatment in the observation group[(110.46±16.69)μmol/L] was higher than that in the control group[(99.04±19.86)μmol/L], the difference was statistically significant( t=-2.551, P<0.05). Conclusion:Heweishupiyin decoction is superior to mosapride citrate tablets in improving the overall symptomatic efficacy and TCM syndrome efficacy of FD patients with liver stagnation and spleen deficiency.Heweishupiyin not only can improve the depression state of FD in the elderly, but also has the effect of improving the gastric electrical rhythm disorder, which may be related to the regulation of serum serotonin levels.

Objective To explore the related risk factors of aortic esophageal fistula (AEF) after esophageal carcinoma operation.Methods According to the design of case-control study and matching proportion of 1:3,18 cases of AEF after esophageal carcinoma operation treated in the thoracic surgery department of Daping Hospital of Third Military Medical University from 2000 to 2015 served as the observation group,and contemporaneous 54 cases of esophageal carcinoma operation,who had approximate basic diseases or risk factors,were selected as the control group,18 pairs were formed.The risk factors possessed by the observation group before disease onset such as age,sex,tumor TNM stage and tumor location served as the matching variables.The non-matching variables including operation time,preoperative body mass index (BMI),amount of intraoperative hemorrhage,preoperative LDL level,anastomosis mode,postoperative pulmonary complications,postoperative arrhythmia,preoperative hypertension,preoperative diabetes and number of removed lymph nodes were performed the case-control study.Results The univariate Logistic analysis preliminarily screened out 5 risk factors,including preoperative obesity,preoperative LDL level,postoperative pulmonary complications,anstomosis mode and number of removed lymph nodes,the difference in other factors was not statistically significant (P＞ 0.05).The multivariate non-conditional Logistic stepwise regression analysis revealed that preoperative obesity (OR =8.63,95 ％ CI=1.35-17.60),preoperative LDL level (OR =0.81,95 ％ CI =0.23-0.98) and the number of intraoperatively removed lymph nodes (OR =0.32,95 ％ CI =0.14-0.59) had statistical differences between the observation group and control group,but the difference in other factors had no statistical significance.Conclusion Preoperative obesity,preoperative LDL level and number of removed lymph nodes might be the risk factors for AEF occurrence after esophageal carcinoma operation.

Objective To study the expression of c -Met protein in gastrointestinal stromal tumor(GIST) and to evaluate its clinicopathological significance.Methods The immunohistochemical technique,EnVision method was used to evaluate the expression of c -Met in 105 cases of GISTs.Results c -Met protein positive rate in GISTs was 9.52%(10 /105),its expression rate was significantly higher in GISTs with >10 /50HPF mitotic activity(P <0.05).c -Met protein expression rate was higher in GISTs which >5cm,moderate or high -risk,or mass located outside the stomach,but the difference was not statistically significant(P >0.05 ).Conclusion c -Met protein expression may related with risk of GISTs.We think that c -Met is worthy of further study for its potential usage as a evaluation indicators of GISTs clinicobiological behavior.

OBJECTIVETo study the expression of fascin-1 protein in breast cancer and to evaluate its correlation with clinicopathologic features of the tumor.

METHODSImmunohistochemical EnVision method was performed to evaluate the expression of fascin-1 in 23 cases of normal breast tissues, 69 cases of benign breast lesions, 58 cases of usual ductal hyperplasia (UDH), 61 cases of ductal carcinoma in situ (DCIS) and 221 cases of breast cancer from March 2007 to December 2011.

RESULTSFascin-1 protein expression rates in normal breast tissues, benign breast lesions, UDH, DCIS and breast cancer were 100.0% (23/23), 89.9% (62/69), 13.8% (8/58), 19.7% (12/61), and 42.1% (93/221), respectively. Fascin-1 expression in normal breast tissues and benign breast lesions was significantly higher than those in UDH, DCIS and breast cancer (P < 0.01); Fascin-1 expression in breast cancer was significantly higher than those in UDH and DCIS (P < 0.01). There was a tendency of increased fascin-1 expression in DCIS compared to UDH, but the difference was not statistically significant (P > 0.05). Fascin-1 positive rates in patients with DCIS grade III (26.8%, 11/41) was significantly higher than that in patients with DCIS grade I-II (1/20, P < 0.05). Fascin-1 protein expression in breast cancer increased with increasing histologic grade and clinical stage (P < 0.01). Fascin-1 protein expression was also significantly higher in tumors with negative estrogen receptor (ER) and progestone receptor (PR) status and > 3 axillary lymph node metastases compared to tumors that were ER and PR positive and ≤ 3 axillary lymph node metastases (P < 0.01 and P < 0.05, respectively). Logistic regression analysis showed that fascin-1 expression correlated positively with high clinical stage (OR = 1.568, 95% CI = 1.029-2.387, P < 0.05) , but negatively with ER expression (OR = 0.149, 95% CI = 0.079-0.281, P < 0.01) .

CONCLUSIONSFascin-1 is highly expressed in normal breast tissues and benign breast lesions, suggesting that it may be a biological marker of mature mammary ductal epithelium. Fascin-1 protein expression shows a significantly increasing trend from UDH, DCIS to invasive breast cancer, suggesting that fascin-1 plays an important role in breast carcinogenesis and may be a potential target for therapy.

Axilla ; Breast ; metabolism ; pathology ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma in Situ ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Carrier Proteins ; metabolism ; Estrogen Receptor alpha ; metabolism ; Female ; Humans ; Hyperplasia ; metabolism ; Lymph Nodes ; metabolism ; Lymphatic Metastasis ; Microfilament Proteins ; metabolism ; Receptors, Estrogen ; metabolism

Objective　 To study the effects of sodium butyrate on proliferatio n, differentiation and apoptosis of immortalized esophagus epithelial cells. Methods　 SHEE, an immortalized human fetal esophageal epithelial cell line induced by HPV18 E6E7, was cultivated in culture flasks and 24-well plates. Two experi m ent groups of cultured cells were treated with 1 and 5 mmol/L of sodium butyrate respectively for 4 days, and one group of untreated cells set aside as control. The numbers of cloned cells were calculated. The ultra-structure of SHEE cells was examined by transmission electron microscopy (TEM). The cell cycle and numbe r of apoptotic cells were measured by flow cytometry, Ki-67 and cytokeratin of ce lls were detected by immunohistochemistry method and F-actin of cells labeled w ith phalloidin was examined by laser confocal scanning microscopy. Results　 Colo ny formations showed a significant decrease in the 2 experiment groups after 4 d ays of culture (P<0.01). In the 1 mmol/L group, the cells at S phase were di minish ed and arrested at G0/G1 phase. Compared with control group, Ki-67 positive cells were found decreased, while F-actin and cyto keratin were increased. Apoptotic cells in 5 mmol/L group were increased markedl y. Conclusions　 Sodium butyrate may induce SHEE cells growth arrest,differentiation and apoptosis. The effects depend on sodium butyrate concentrat ion and time of exposure. Whether it can be used in combination with other antic ancer drugs should be further studied.