Objective To compare the application values of the Ranson score,Bedside Index for Severity in Acute Pancreatitis(BISAP),CT Severity Index(CTSI)and Oxford Acute Severity of Illness Score(OA-SIS)in forecasting the new onset organ failure in the patients with severe acute pancreatitis(SAP).Methods The study was a retrospective analysis.A total of 126 cases of SAP receiving by the intensive care unit(ICU)and emergency ICU(EICU)of the Second Affiliated Hospital of Chongqing Medical University from January 2015 to June 2023 served as the study subjects.The clinical data of the patients were collected.The first time OASIS score,Ranson score,BISAP score and CTSI score were calculated within 48 h after the patients ente-ring ICU.The new onset organ failure served as the clinical outcome.The random forest and least absolute shrinkage and selection operator(LASSO)regression were used to screen the risk factors for new onset organ failure.The multivariate logistic regression was adopted to analyze the correlation between the four scoring systems and new onset organ failure in the SAP patients.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were adopted to analyze the predictive efficiency of 4 kinds of scoring sys-tems.Results The age in the organ failure group was higher than that in the non-organ failure group(P=0.039).The OASIS,Ranson,BISAP and CTSI scores in the organ failure group all were higher than those in the non-organ failure group(P＜0.05).The random forest and LASSO regression analysis results showed that Lac,Cr and myoglobin were the most important variables affecting the new onset organ failure in SAP pa-tients.The OASIS score(OR=1.27,95％CI:1.06-1.51,P=0.009)and Ranson score(OR=1.88,95％CI:1.03-3.43,P=0.040)were the independent influencing factors for predicting the new onset organ fail-ure in SAP patients.The ROC curve results showed that the area under the curve(AUC)of the OASIS score was the highest(AUC=0.830,95％CI:0.743-0.916).Conclusion The OASIS score is an independent risk factor for predicting the new onset organ failure in SAP patients,moreover has the highest predictive efficiency in predicting the new onset organ failure.

Objective : To investigate the effect of chemotherapeutic drug resistance induced by CLDN18⁃ARH⁃GAP26 fusion mutation gene in gastric cancer cells , and to investigate the sensitization effect of ginsenoside in the treatment of chemotherapeutic drug resistance caused by the expression of CLDN18⁃ARHGAP26 fusion mutation gene. Methods : The side population (SP) cells and non⁃side population ( NSP) cells of gastric cancer cell line BGC⁃823 were labeled with immunomagnetic bead antibody , and the lentiviral vector with overexpression of CLDN18⁃ARHGAP26 fusion mutation gene was selected for transfection with NSP cells. qPCR was used to detect the mRNA levels of CLDN18⁃ARHGAP26 fusion mutation and ATP Binding Cassette Subfamily G Member 2 (ABCG2) . The expression of EMT⁃related proteins E ⁃Cadherin and Vimentin was detected by Western blot. The sensitivity of transfected cells to oxaliplatin was detected by CCK⁃8. The effect of ginsenoside on drug resistance of transfected cells was detected by CCK ⁃ 8 . The expression of E ⁃ Cadherin and Vimentin in transfected cells was detected by Western blot after ginsenoside treatment. Results : qPCR detection showed that the expression of CLDN18⁃ARH⁃GAP26 fusion mutant gene in NSP cells transfected with overexpressed CLDN18⁃ARHGAP26 fusion mutant gene was significantly higher than that of the non⁃transfected group , and the expression of ABCG2 mRNA was significantly cells with over⁃expressed CLDN18⁃ARHGAP26 fusion mutation gene was lower than that in the non⁃transfected transfected cells to oxaliplatin was lower than that in the non⁃transfected group. The survival rate of transfected cells sion of E ⁃Cadherin protein in the transfected cells treated with ginsenoside was higher than that in the untreated group , and the expression of Vimentin protein was lower than that in the untreated group. Conclusion Ginsenoside can reverse cell EMT transformation and oxaliplatin resistance induced by CLDN18⁃ARHGAP26 fusion mutated gene expression in gastric cancer tissues.

Objective To analyze the effects of laparoscope-assisted Ivor-Lewis surgery on perioperative stress,immune responses and intestinal barrier function in elderly patients with esophageal cancer.Methods A prospective study including 55 elderly esophageal cancer patients undergoing laparoscope-assisted Ivor Lewis surgery (the treatment group,n =25) and Ivor-Lewis surgery(the control group,n=25) was conducted.The white blood cell count,neutrophil-to-lymphocyte ratio,percentages of CD4 and CD8 cells,CD4/CD8 ratio,C reactive protein (CRP) and D-lactic acid levels were compared between the two groups before and at 1,4 and 7 d after operation.Results The white blood cell count(t =2.689,P =0.010) and neutrophil-to-lymphocyte ratio (t =3.300,P =0.002)were lower in the treatment group than in the control group at 1 d after operation.The percentage of CD4 cells was higher in the treatment group than in the control group at 1 d(t =2.242,P =0.029)and 4 d(t =2.031,P =0.047) after operation.The percentage of CD8 cells was higher in the treatment group than in the control group at 1 d after operation(t =2.041,P=0.046).The CD4/CD8 ratio was higher in the treatment group than in the control group at 1 d(t =2.833,P =0.007)and 4 d(t=2.111,P=0.036)after operation.The CRP level was lower in the treatment group than in the control group at 1 d(t=2.267,P=0.028)and 4 d(t =2.111,P =0.036)after operation.The D-lactic acid level was lower in the treatment group than in the control group at 1 d(t =2.267,P=0.028),4 d (t =7.967,P ＜ 0.01) and 7 d (t =2.541,P =0.014) after operation.Conclusions Laparoscopeassisted Ivor-Lewis surgery has good protective effects on perioperative stress,immune responses and intestinal barrier function in elderly patients with esophageal cancer.

Objective To compare the effect of breast conserving surgery and modified radical mastectomy on the clinical efficacy of patients with early breast cancer.Methods CNKI,Chinese Journal Full-text Database (CJFD),China Biology Medicine Disc (CBMdisc),China Dissertation Database (Chinese Dissertation Database,CDDB) google academic and other databases were comprehensive searched.And then the search time was limited to between January 1,2015 and September 1,2017.Key words can be locked for breast conserving surgery,improved surgery for breast surgery,case-control studies,etc.,and then meet the conditions of the literature into the study,for a retrospective analysis.The authors reviewed the literature independently,extracted data and evaluated the risk of bias,and used Review Manager 5.3 software for systematic analysis.Results A total of 1 093 patients with early breast cancer were enrolled in the study.The Meta-analysis showed:there was a significant difference in operation time between the two groups(MD =-30.71,95％ CI:-31.96--29.46,P ＜ 0.01);there was a significant difference in intraoperative blood loss between the two groups(MD =-53.30,95％ CI:-55.38--51.22,P ＜ 0.01);there was a significant difference in postoperative hospital stay (MD =-5.66,95％CI:-7.17--5.17,P ＜0.01) and the incidence of complications (OR =0.30,95％ CI:0.19-0.47,P ＜ 0.01)compared with modified radical mastectomy in early breast cancer patients.There was no significant difference between the two groups in the postoperative recurrence and metastasis (OR =0.78,95％ CI:0.54-1.13,P =0.19).Conclusions In the choice of surgical methods,breast-conserving therapy is better than modified radical surgery,and postoperative recurrence and metastasis rate has no significant difference.