1.Clinical study on the combination of systemic immune inflammation index and neutrophil lymphocyte ratio in guiding immunotherapy for advanced gastric cancer
Zhenfeng WANG ; Junpeng CHANG ; Deling SUI ; Guangyong LIU
International Journal of Surgery 2024;51(1):16-21
Objective:To analyze the significance of systemic immune inflammatory index (SII) combined with neutrophil lymphocyte ratio (NLR) in the treatment of advanced gastric cancer with PD-1/PD-L1 inhibitors.Methods:The clinical data of 90 patients with stage Ⅳ gastric adenocarcinoma who received immunotherapy from January 2020 to January 2023 were retrospectively analyzed, including 70 males and 20 females, aged from 36 to 80 years, with an average age of (53.76±15.58) years. The clinicopathological features and follow-up data were collected. SPSS 26.0 software was used to conduct statistical analysis. The critical values of NLR, SII, PLR and MLR were calculated, and the overall survival (OS) and progression free survival (PFS) of patients with different levels of markers were analyzed. The independent predictive factors of PFS and OS were determined, and the predictive value of risk factors for PFS and OS in patients with gastric cancer was evaluated.Results:The median follow-up time of all patients was 27.3 months, and the median PFS and OS were 10.0 months and 17.7 months, respectively. The area under the curve (AUC) of NLR and SII for predicting PFS and OS were>0.7, the critical values NLR were 4.75 and 3.85, and SII were 1154.67 and 887.90, respectively. PFS and OS in patients with high NLR, high MLR, high PLR and high SII were lower than those in patients with low levels. ECoG PS≥ 1, high NLR and high SII were independent influencing factors of disease progression or death. The AUC of the combination of NLR, ECoG PS and SII was 0.761, which was higher than that of any single factor. The fewer the number of risk factors, the longer the PFS and OS.Conclusions:NLR and SII are effective predictors of PFS and OS in patients with advanced gastric cancer receiving immunotherapy. Pre treatment detection of NLR and SII can provide reliable guidance for immunotherapy of advanced gastric cancer.
2.Effect of Bufeitang on Lung-gut Axis in Rats with Lung Qi-deficiency Syndrome of Chronic Obstructive Pulmonary Disease
Junxi SHEN ; Xing ZHU ; Yunzhi CHEN ; Huaiquan LIU ; Cancan CHU ; Yu ZHANG ; Gang SU ; Wen LI ; Changjun XU ; Pingzhen TONG ; Xinran YU ; Guangyong YANG ; Ying DENG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(7):47-56
ObjectiveTo investigate the effect of Bufeitang on intestinal flora of rats with lung Qi-deficiency syndrome of chronic obstructive pulmonary disease(COPD), and to explore the mechanism of traditional Chinese medicine in regulating intestinal flora and thus restoring the balance of lung-gut axis. MethodA total of 84 rats were randomly divided into 7 groups, including blank group, model group, fecal bacterial transplantation(FMT) group, dexamethasone group and low, medium and high dose groups of Bufeitang, 12 rats in each group. Except for the blank group, cigarette and sawdust fumigation combined with intratracheal instillation of lipopolysaccharide(LPS) were used to establish the COPD rat model with lung Qi-deficiency syndrome in all other groups. The low, medium and high dose groups of Bufeitang were intragastric administrated with Bufeitang(3.645, 7.29, 14.58 g·kg-1), the FMT group was given fecal bacteria liquid enema(10 mL·kg-1), dexamethasone group was given dexamethasone acetate tablet suspension by gavage(0.135 mg·kg-1), the blank group and model group were given equal amount of distilled water. Fresh feces were collected after 28 d of continuous intervention for 16S rRNA gene sequencing. Lung and colon tissues were stained with hematoxylin-eosin(HE) for pathomorphological observation, and enzyme-linked immunosorbent assay (ELISA) was performed to detect the contents of tumor necrosis factor-α(TNF-α) and interleukin-8(IL-8) in lung tissues. ResultCompared with the blank group, the model group showed severe abnormal lung tissue structure with alveolar atrophy and collapse accompanied by severe inflammatory cell infiltration. Compared with the model group, the extent of injury was significantly improved, and inflammatory cell infiltration was reduced with basically normal alveolar structure in the high dose group of Bufeitang. Compared with the blank group, the model group had severely abnormal colonic tissue structure, the epithelial cells in the mucosal layer were eroded and shed, the number of inflammatory cells increased, the submucosal layer was edematous and the gap was enlarged. Compared with the model group, the extent of damage was significantly improved in the medium and high dose groups of Bufeitang, the epithelial cells in the mucosal layer were neatly and closely arranged, with only a small amount of inflammatory cell infiltration and no significant degeneration. Compared with the blank group, the TNF-α and IL-8 levels of lung tissue in the model group were significantly increased(P<0.01). Compared with the model group, the TNF-α and IL-8 levels of lung tissues in the low, medium and high dose groups of Bufeitang were significantly decreased(P<0.01). Bufeitang significantly modulated the number of bacteria species as well as alpha and beta diversity of model rats, corrected the return of intestinal flora to normal abundance and diversity, and positively regulated 4 differential phyla(such as Firmicutes, Proteobacteria) and 13 differential genera(such as Turicibacter, Lactobacillus, Anaerobiospirillum, Intestinimonas) in COPD model rats with lung Qi-deficiency syndrome, and down-regulated 2 carbohydrate metabolic pathway functions, including the pentose phosphate pathway(non-oxidative branch) Ⅰ and the Calvin-Benson-Bassham cycle. ConclusionBufeitang can modulate the abundance and diversity of intestinal flora species, affect the function of metabolic pathways, repair the structure of lung and colon tissues, regulate the level of inflammatory factors, and thus improve COPD with lung Qi-deficiency syndrome. The mechanism may be related to its regulation of inflammation-related intestinal flora to restore the balance of lung-gut axis in COPD with lung Qi-deficiency syndrome.
3.Research progress on effects and mechanisms of short-term exposure to ambient fine particulate matter and its components on blood pressure
Lingling SHEN ; Guangyong LIU ; Yichun BAI ; Jie SONG ; Juan LI ; Weidong WU ; Zhen AN
Journal of Environmental and Occupational Medicine 2023;40(9):1095-1101
Elevated blood pressure is one of the major contributors to cardiovascular disease and premature death. The exposure to ambient fine particulate matter (PM2.5) is closely associated with changes in blood pressure, and even short-term exposure to PM2.5 can lead to an increase in blood pressure. PM2.5 is a complex mixture that exerts different toxicities and triggers increased blood pressure through various mechanisms. Therefore, in this article, we provided a comprehensive review of published studies on the effects of short-term exposure to PM2.5 and its components on blood pressure, and elaborated potential mechanisms from four aspects, including oxidative stress and inflammatory response, endothelial dysfunction, autonomic nervous system disorders and hypothalamus-pituitary-adrenal axis activation, and epigenome alteration. Given the limitations of existing research, future prospective studies can be conducted on diverse populations, using more precise exposure measurement methods and multi-omics approaches, to further elucidate the mechanisms underlying the effects of PM2.5 and its various components on blood pressure. The findings would provide a theoretical foundation for effective protection of public health, particularly vulnerable groups.
4.Effect of pallidal deep brain stimulation on motor and non-motor functions in patients with Meige syndrome
Wentao ZHENG ; Qingpei HAO ; Yezu LIU ; Hu DING ; Guangyong WU ; Zihao ZHANG ; Ruen LIU
Chinese Journal of Neuromedicine 2023;22(8):801-807
Objective:To investigate the effect of bilateral globus pallidus internus deep brain stimulation (GPi-DBS) on motor performance, quality of life, sleep quality, neuropsychological status, and mood in patients with Meige syndrome.Methods:The clinical data of 17 patients with Meige syndrome accepted bilateral GPi-DBS in Department of Neurosurgery, People's Hospital of Peking University from May 2019 to March 2021 were retrospectively analyzed. Established and validated rating scales were used to assess the motor performance, quality of life, sleep quality, neuropsychological status, and mood at baseline, and 1 and 2 years after GPi-DBS.Results:Burke-Fahn-Marsden dystonia rating scale (BFMDRS) motor total scores decreased from 14.4±6.2 at baseline to 4.3±2.2 and 3.5±1.9 at 1 and 2 years after GPi-DBS, with significant differences ( P<0.05). BFMDRS disability total scores decreased from 6.2±4.0 at baseline to 2.8±2.0 and 2.2±1.5 at 1 and 2 years after GPi-DBS, with significant differences ( P<0.05). In 36-item Short-Form Health Survey (SF-36), the scores of physical function, role-physical, general health sub-items at 1 and 2 years after GPi-DBS were significantly higher than those at baseline ( P<0.05). No significant differences were noted in scores of sleep quality, neuropsychological function, or mood scales at 1 and 2 years after GPi-DBS compared with those at baseline ( P>0.05). Conclusion:Bilateral GPi-DBS is effective and safe in Meige syndrome, which can improve dystonic symptom and quality of life without adverse effects on sleep quality, neuropsychological function, or emotional status.
5.Gray matter changes in primary glossopharyngeal neuralgia: a voxel-based morphometry study
Wentao ZHENG ; Qingpei HAO ; Gaoquan LYU ; Yezu LIU ; Guangyong WU ; Zihao ZHANG ; Ruen LIU
Chinese Journal of Neuromedicine 2023;22(12):1220-1228
Objective:To explore the pathogenesis of glossopharyngeal neuralgia (GPN) in central nervous system from perspective of brain morphology.Methods:A prospective study was performed. Twenty-seven patients with right primary GPN admitted to Department of Neurosurgery, People's Hospital of Peking University from April 2019 to June 2023 and 27 healthy subjects (controls) matched with age, gender, dominant hand, and education level during the same period were recruited. These patients were divided into GPN with neurovascular compression group ( n=18) and GPN without neurovascular compression ( n=9) based on intraoperative presence of neurovascular compression. SPM8 software based on Matlab R2017b programming platform and VBM8 toolbox were used to process the whole-brain high-resolution 3D-T1 brain structural image data of the participants and analyze the differences in the gray matter volume of each brain region between the 2 groups. Pearson correlation was applied to analyze the correlations of gray matter volumes in brain regions enjoying significant difference with baseline data and pain characteristics of these GPN patients. Results:Compared with controls, patients with GPN had significantly reduced gray matter volumes in the left anterior cingulate gyrus, middle temporal gyrus, transverse temporal gyrus, precentral gyrus, postcentral gyrus, right insula, thalamus, inferior parietal lobule, precentral gyrus, middle temporal gyrus, and inferior temporal gyrus ( P<0.05, FDR corrected). Compared with GPN patients with neurovascular compression, GPN patients without neurovascular compression had significantly reduced gray matter volume in the bilateral anterior cingulate gyrus ( P<0.05, FDR corrected). Changes of gray matter volume in the right insula were negatively correlated with disease duration of GPN patients ( r=-0.521, P=0.005). Conclusion:GPN patients have extensive gray matter atrophy in the brain, which may play an essential role in GPN development and maintenance.
6.The role of cAMP /Epac / Rap1 signaling pathway regulate the secretion of IL-1 β, TNF-α, BDNF from NG2 cell and the effect of Jujuboside A
Tingting Yang ; Hui Wang ; Peng Shi ; Liu Teng ; Yue Li ; Min Du ; Xiaohua Tu ; Guangyong Yang ; Ying Deng
Acta Universitatis Medicinalis Anhui 2023;58(2):265-270
Objective:
To investigate whether the cyclic adenosine monophosphate (cAMP) / exchange proteins directly activated by cAMP (Epac) / ras-related protein 1 ( Rap1 ) signalling pathway is involved in the intervening mechanisms of interleukin-1 β (IL-1 β) ,tumor necrosis factor-α (TNF-α) ,brain-derived neurotrophic factor (BDNF) and Jujuboside A(JuA) secretion by NG2 cells.
Methods:
NG2 cells were cultured in vitro and the experiment was divided into control group ,pertussis toxin ( PTX) group ,ESI-09 group,JuA group and positive drug group.The effect of different concentrations of JuA on the survival rate of NG2 cells was detected by CCK-8 method,and the expression of IL-1 β , TNF-α , BDNF,cAMP,Epac,Rap1 mRNA and protein in each group was detected by RT-PCR and Western blot.
Results:
Compared with the control group,the PTX group decreased the expression of IL-1 β and TNF-α mRNA and protein (P<0. 01) and increased the expression of cAMP and BDNF mRNA and protein (P<0. 01) ; the ESI-09 group increased the expression of IL-1 β and TNF-α mRNA and protein (P < 0. 05) and decreased the expression of BDNF,Epac and Rap1 mRNA and protein expression (P<0. 01) ; the JuA group and positive drug group increased IL-1 β , TNF-α , BDNF,cAMP,Epac,Rap1 mRNA and protein expression (P<0. 01) .
Conclusion
The cAMP / Epac / Rap1 signaling pathway is involved in the secretion of IL-1 β , TNF- α , and BDNF by NG2 cells.JuA may act on cAMP / Epac / Rap1 signaling pathway to affect the secretion of BDNF by NG2 cells.
7.Effects of compression treatment on occurrence of venous thromboembolism after tension-free inguinal hernia repair
Ting ZHANG ; Wenbo ZHENG ; Zhibo YAN ; Minggang WANG ; Yuchen LIU ; Mingwei ZHONG ; Guangyong ZHANG
Chinese Journal of Digestive Surgery 2021;20(7):790-798
Objective:To investigate the effects of compression treatment on occurrence of venous thromboembolism (VTE) after tension-free inguinal hernia repair.Methods:The retrospective cohort study was conducted. The clinical data of 13 263 patients with inguinal hernia who were admitted to 58 medical centers from January to December in 2017 were collected, including 1 668 in Beijing Chaoyang Hospital of Capital Medical University, 782 in East Hospital Affiliated to Tongji University, 558 in Huadong Hospital of Fudan University, 525 in Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, 488 in Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 382 in Tianjin People's Hospital, 378 in Peking University Third Hospital, 364 in Beijing Hospital, 356 in Shengjing Hospital of China Medical University, 348 in Huashan Hospital of Fudan University, 348 in Sichuan Provincial People's Hospital, 328 in Affiliated Hospital of Zunyi Medical University, 304 in Beijing Luhe Hospital of Capital Medical University, 296 in People's Hospital of Changshou District in Chongqing, 290 in Anhui Provincial Hospital, 281 in the First Affiliated Hospital of Dalian Medical University, 281 in Xinjiang Uygur Autonomous People's Hospital, 247 in Qilu Hospital of Shandong University, 220 in Wuhan NO.1 Hospital, 214 in the First Hospital of China Medical University, 213 in West China Hospital of Sichuan University, 206 in the Second Affiliated Hospital of Chongqing Medical University, 202 in Taiyuan Central Hospital of Shanxi Medical University, 197 in the First Affiliated Hospital of Wenzhou University, 191 in Zhongda Hospital of Southeast University, 190 in Tianjin Medical University General Hospital, 189 in Xuzhou Central Hospital, 188 in the First Affiliated Hospital of Harbin Medical University, 187 in the Second Hospital Affiliated to Naval Medical University, 175 in Chengdu Fifth People's Hospital, 173 in Tianjin Nankai Hospital, 172 in the Fourth Affiliated Hospital of China Medical University, 172 in Zhangjiakou First Hospital, 161 in Henan Provincial People's Hospital, 153 in the First Affiliated Hospital of Xi'an Jiaotong University, 149 in Shandong Provincial Hospital, 142 in the Second Hospital of Shandong University, 137 in the First Affiliated Hospital of Hunan University of Medicine, 136 in the Fourth Hospital of Harbin Medical University, 127 in Pingjiang District of the First Affiliated Hospital of Soochow University, 102 in the Central Hospital of Wuhan, 100 in the First Affiliated Hospital of Soochow University, 98 in Peking Union Medical College Hospital of Chinese Academy of Medical Sciences, 97 in the First Affiliated Hospital of Chongqing Medical University, 96 in Xijing Hospital Affiliated to Air Force Medical University, 90 in the Fourth Medical Center of Chinese PLA General Hospital, 81 in Hunan Provincial Hospital of Traditional Medicine, 80 in the First Hospital of Tsinghua University, 80 in Xinhua Hospital of Hubei Province, 61 in the First Affiliated Hospital of Zhengzhou University, 57 in Peking University International Hospital, 50 in Peking University First Hospital, 39 in Zhongnan Hospital of Wuhan University, 38 in Jilin Yan'an Hospital, 37 in China-Japan Union Hospital of Jilin University, 20 in Taikang Xianlin Drum Hospital, 16 in Chinese PLA General Hospital, 3 in the First Affiliated Hospital of Fujian Medical University. There were 11 852 males and 1 411 females, aged from 18 to 102 years, with a median age of 64 years. Of 13 263 patients, 9 995 with compression treatment after tension-free inguinal hernia repair were divided into compression group and 3 268 without compression treatment after tension-free inguinal hernia repair were divided into non-compression group. Observation indicators: (1) compression treatment of patients in the compression group; (2) occurrence of VTE after tension-free inguinal hernia repair in the two groups; (3) analysis of influencing factors for VTE after tension-free inguinal hernia repair. Follow-up using telephone interview was performed to detect history of patient's thrombosis, medical history of patient's family and the incidence of postoperative VTE up to February 2018. Measurement data with skewed distribution were represented as M ( P25, P75) or M (range), and comparison between groups was analyzed using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis and multivariate analysis were conducted using the Logistic regression model. Results:(1) Compression treatment of patients in the compression group: of the 9 995 patients in the compression group, 6 086 underwent compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution, 1 881 underwent compression treatment with trusses, 745 underwent compression treatment with girdles, 675 underwent compression treatment with elastic underwear combined with 0.5 kg of sandbag, and 608 underwent compression treatment with elastic underwear. (2) Occurrence of VTE after tension-free inguinal hernia repair in the two groups: patients of the two groups after matching were followed up. Occurrence of VTE after matching were 15 and 1 in the compression group and non-compression group, respectively, showing no significant difference between the two groups ( χ2=2.010, P>0.05). (3) Analysis of influencing factors for VTE after tension-free inguinal hernia repair: results of univariate analysis showed that cases with varix of lower limb, cases with oral contracep-tives or hormone replacement therapy history, cases with VTE history, clinical classification, clinical typing, surgical method, cases with anticoagulant drugs history, cases undergoing oral antiplatelet drugs, cases undergoing postoperative VTE prevention with medication were related factors for occurrence of VTE after tension-free inguinal hernia repair ( odds ratio=13.98, 37.71, 19.21, 4.43, 4.21, 0.07, 0.08, 0.10, 31.04, 95% confidence interval: 3.15?62.11, 8.35?170.24, 6.15?60.00, 1.43?13.76, 1.20?14.82, 0.01?0.49, 0.02?0.27, 0.04?0.29, 8.53?112.93, P<0.05). Results of multivariate analysis showed that cases with VTE history and surgical method were independent influencing factors for occurrence of VTE after tension-free inguinal hernia repair ( odds ratio=7.78, 11.19, 95% confidence interval: 2.06?29.42, 1.45?86.55, P<0.05). Conclusion:Cases with VTE history and surgical method are independent influencing factors for occurrence of VTE after tension-free inguinal hernia repair.
8.Differential miRNA expression in the peripheral blood of patients with Keshan disease and its mechanism
Yong LIU ; Youzhang XIANG ; Jingwen LIU ; Guanfeng CHONG ; Yuehai WANG ; Guangyong HUANG
Chinese Journal of Endemiology 2021;40(8):610-615
Objective:Through differential miRNA expression profiles and bioinformatics in the peripheral blood of patients with Keshan disease (KD) and healthy control, to explore the possible pathogenesis of KD.Methods:Ten patients with chronic KD (KD group) were selected in the severe disease area of KD in Wulian County, and 10 healthy subjects (control group) were selected in non-KD area of Dongchangfu District, Shandong Province. Blood sample of elbow vein was collected and plasma was separated. RNA-seq technology was used to construct the differential expression profiles of miRNA in KD and control groups. Target mRNAs were screened using Starbase, miRTarBase, miRDB and TargetScan. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were conducted to investigate the possible pathogenesis of KD.Results:Compared the control group and KD group, 132 differentially expressed miRNAs were screened out, including 90 upregulated and 42 downregulated miRNAs. Through Starbase, miRTarBase, miRDB and TargetScan, 53 miRNAs were obtained, 737 targeted mRNAs were obtained. GO analysis showed that the differential genes were mainly involved in the biological processes of Ras protein signal transduction, transmembrane transport, cell cycle regulation, cell adhesion, etc. KEGG pathway analysis showed that the differential genes were mainly involved in viral infection, endocytosis, adhesion spot and actin regulation.Conclusion:In this study, RNA-seq technology is used to obtain differential miRNA expression profiles of KD patients and healthy control, and target pathogenic genes and signaling pathways that may be related to KD are screened out.
9.Effects of compression treatment on occurrence of seroma after tension-free inguinal hernia repair based on propensity score matching
Chao GAO ; Zhibo YAN ; Minggang WANG ; Yuchen LIU ; Mingwei ZHONG ; Guangyong ZHANG
Chinese Journal of Digestive Surgery 2020;19(7):742-750
Objective:To investigate the effects of compression treatment on occurrence of seroma after tension-free inguinal hernia repair.Methods:The propensity score matching and retrospective cohort study was conducted. The clinical data of 6 600 patients with unilateral inguinal hernia who were admitted to 51 medical centers from January to December in 2017 were collected, including 917 in Beijing Chaoyang Hospital of Capital Medical University, 451 in East Hospital Affiliated to Tongji University, 363 in Huadong Hospital of Fudan University, 307 in Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 254 in Sir Run Run Shan Hospital of Zhejiang University School of Medicine, 222 in Sichuan Provincial People′s Hospital, 221 in Beijing Luhe Hospital of Capital Medical University, 202 in Shengjing Hospital of China Medical University, 191 in Anhui Provincial Hospital, 181 in Affiliated Hospital of Zunyi Medical University, 174 in Tianjin People′s Hospital, 169 in the First Affiliated Hospital of Dalian Medical University, 155 in People′s Hospital of Changshou in Chongqing, 152 in Qilu Hospital of Shandong University, 146 in the First Affiliated Hospital of Fujian Medical University, 136 in Taiyuan Central Hospital of Shanxi Medical University, 134 in First Hospital of Wuhan, 122 in Xinjiang Uygur Autonomous People′s Hospital, 122 in the Second Affiliated Hospital of Chongqing Medical University, 118 in the Second Hospital Affiliated to Naval Medical University, 113 in Xuzhou Central Hospital, 112 in the First Affiliated Hospital of Harbin Medical University, 112 in the First Affiliated Hospital of Wenzhou Medical University, 102 in the Second Hospital of Shandong University, 100 in Tianjin Hospital of Itcwm Nankai Hospital, 99 in Shandong Provincial Hospital, 90 in Huashan Hospital of Fudan University, 88 in Henan Provincial People′s Hospital, 87 in West China Hospital of Sichuan University, 86 in Zhangjiakou First Hospital, 86 in the First Affiliated Hospital Soochow University, 77 in the Fourth Affiliated Hospital of China Medical University, 75 in Tianjin Medical University General Hospital, 72 in the First Affiliated Hospital of Hunan University of Medicine, 67 in First Affiliated Hospital of Xi′an Jiaotong University, 49 in the First Hospital of China Medical University, 49 in Hunan Provincial Hospital of Traditional Medicine, 48 in Xijing Hospital Affiliated to Air Force Medical University, 47 in Xinhua Hospital of Hubei Province, 46 in the First Hospital of Tsinghua University, 45 in the First Affiliated Hospital of Chongqing Medical University, 34 in the First Affiliated Hospital of Zhengzhou University, 29 in Peking University International Hospital, 28 in Jilin Yan′an Hospital, 25 in China-Japan Union Hospital of Jilin University, 22 in Peking University Third Hospital, 22 in Peking University First Hospital, 20 in the Fourth Affiliated Hospital of Harbin Medical University, 19 in Chengdu Fifth People′s Hospital, 8 in Chinese PLA General Hospital, 6 in Taikang Xianlin Drum Hospital. There were 5 850 males and 750 females, aged (57±16)years, with the range from 18 to 92 years. Of the 6 600 patients, 4 939 with compression treatment after tension-free inguinal hernia repair were divided into compression group and 1 661 without compression treatment after tension-free inguinal hernia repair were divided into non-compression group. Observation indicators: (1) the propensity score matching conditions and comparison of general data between the two groups after matching; (2) compression treatment of patients in the compression group after matching; (3) occurrence of seroma after tension-free inguinal hernia repair in the two groups after matching; (4) analysis of influencing factors for seroma after tension-free inguinal hernia repair. Follow-up using outpatient examination was performed at postoperative 14 days and 30 days to detect occurrence of seroma after tension-free inguinal hernia repair of patients up to January 2018. The propensity score matching was realized using the nearest neighbor method with 1∶1 ratio and caliper setting as 0.01. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analysed using the t test. Measurement data with skewed distribution were represented as M ( P25, P75) or M (range), and comparison between groups was analysed using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analysed using the chi-square test. Univariate analysis and multivariate analysis were conducted using the Logistic regression model. Results:(1) The propensity score matching conditions and comparison of general data between the two groups after matching: 3 322 of 6 600 patients had successful matching, including 1 661 in each group. Cases with smoking history, cases with coronary heart disease, cases with diabetes, cases with reducible hernia, irreducible hernia, incarcerated hernia, strangulated hernia (hernia grading), cases with Lichtenstein repair, cases with transabdominal preperitoneal patch repair, totally extraperitoneal repair(surgical methods), operation time, cases with emergency operation before propensity score matching were 1 110, 273, 333, 4 606, 63, 262, 8, 1 636, 2 515, 788, 60 minutes(50 minutes, 90 minutes), 155 in the compression group, and 233, 55, 87, 1 572, 28, 57, 4, 478, 941, 242, 60 minutes(45 minutes, 80 minutes), 29 in the non-compression group, respectively, showing significant differences in the above indicators between the two groups ( χ2=54.713, 12.927, 4.721, 11.218, 16.656, Z=-7.598, χ2=8.891, P<0.05). After propensity score matching, the above indicators were 231, 63, 82, 1 579, 20, 61, 1, 526, 826, 309, 60 minutes(45 minutes, 81 minutes), 34 in the compression group, and 233, 55, 87, 1 572, 28, 57, 4, 478, 941, 242, 60 minutes(45 minutes, 80 minutes), 29 in the non-compression group, respectively, showing no significant difference in the above indicators between the two groups ( χ2=0.018, 0.624, 0.157, 0.159, 0.240, Z=0.001, χ2=0.468, P>0.05). (2) Compression treatment of patients in the compression group after matching: of the 1 661 patients in the compression group after matching, 968 underwent compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution, 109 underwent compression treatment with trusses, 112 underwent compression treatment with girdles, 311 underwent compression treatment with elastic underwear and 161 underwent compression treatment with elastic underwear combined with 0.5 kg of sandbag. (3) Occurrence of seroma after tension-free inguinal hernia repair in the two groups after matching: patients of the two groups after matching were followed up at postoperative 14 days and 30 days. Occurrence of seroma after matching were 44 and 15 in the compression group and non-compression group, respectively, showing a significant difference between the two groups ( χ2=13.299, P<0.05). (4) Analysis of influencing factors for seroma after tension-free inguinal hernia repair. Results of univariate analysis showed that cases with direct inguinal hernia, cases undergoing compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution were related factors for occurrence of seroma after tension-free inguinal hernia repair ( odds ratio=0.518, 4.689, 95% confidence interval: 0.271-0.989, 2.730-8.055, P<0.05). Results of multivariate analysis showed that compared with no compression treatment, cases undergoing compression treatment with 0.5kg sandbag or 500 mL pack of 0.9% sodium chloride solution was an independent risk factor for occurrence of seroma after tension-free inguinal hernia repair ( odds ratio=4.698, 95% confidence interval: 2.734-8.073, P<0.05). Conclusion:Compared with no compression treatment, cases undergoing compression treatment with 0.5 kg of sandbag or 500 mL of packed 0.9% sodium chloride solution is an independent risk factor for occurrence of seroma after tension-free inguinal hernia repair.
10.Comparative analysis of lncRNA-mRNA co-expression between Keshan disease and dilated cardiomyopathy
Guangyong HUANG ; Youzhang XIANG ; Jingwen LIU ; Yuehai WANG ; Jing WANG ; Miaomiao CAO ; Xuesong WANG ; Guanfeng CHONG ; Wenbo YANG
Chinese Journal of Endemiology 2019;38(5):361-367
Objective By constructing the differential expression profile of lncRNA/mRNA in peripheral blood plasma of patients with Keshan disease (KSD) and dilated cardiomyopathy (DCM),to explore the commonality and characteristics of the two diseases in molecular mechanism.Methods Ten patients with chronic KSD were selected in the severe disease area of KSD in Shandong Province,and 10 cases of DCM and 10 healthy subjects (control group) were selected in non-KSD area.Blood of elbow vein was collected and plasma was separated.RNA-seq technology was used to construct the differential lncRNA/mRNA expression profile between KSD and control group,DCM and control group,and co-expression and specific expression of partial genes in KSD and DCM were analyzed through Wien analysis.The lncRNA-mRNA co-expression network maps of specific part of KSD,specific part of DCM and common part of the two diseases were constructed,and Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were applied to distinguish the biological function of the two diseases.Results Compared with control group,102 dysregulated mRNAs and 22 dysregulated lncRNAs showed the same trend in KSD and DCM.And 3 606 mRNAs and 451 lncRNAs were only differentially expressed in KSD group,217 mRNAs and 137 lncRNAs were only differentially expressed in DCM group.The differentially expressed lncRNA/mRNA shared between the KSD and DCM groups were mainly about viral transcription,immuno-inflammatory response,oxidative stress signaling pathways.The KSD specific lncRNA/mRNA mainly participated in cell membrane damage and viral myocarditis.The DCM specific lncRNA/mRNA mainly regulated mitochondrial structure and oxidative phosphorylation related enzymes.Conclusion The differentially expressed lncRNA/mRNA shared in KSD and DCM groups are mainly involved in viral transcription,oxidative stress signaling pathways;KSD specific lncRNA/mRNA are mainly related to cell membrane damage and viral myocarditis;DCM specific lncRNA/mRNA mainly regulate mitochondrial structure.


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