Objective To explore the warning value of expression of phosphoglycerate mutase 1(PGAM1),microRNA-433-3p(miR-433-3p)and cyclin-dependent kinase 1(CDK1)in surgical specimens for early recurrence and metastasis after laparoscopic surgery for colorectal cancer(CRC).Methods Clinical materials of 120 patients with laparoscopic surgery for CRC were retrospectively an-alyzed.Based on the incidence status of recurrence and metastasis within one year after surgery,the patients were divided into recurrence group(n=31)and non-recurrence group(n=89).The clinical materials and the expression levels of PGAM1,miR-433-3p,and CDK1 in surgical specimens were compared between the two groups.Logistic regression analysis was conducted to explore the impacts of PGAM1,miR-433-3p and CDK1 on recurrence and metastasis after laparoscopic surgery for CRC.Re-ceiver operating characteristic(ROC)curve was drawn to analyze the values of PGAM1,miR-433-3p and CDK1 alone as well as their combination for predicting recurrence andmetastasis after laparoscopic surgery,and external validation was performed.Results The levels of PGAM1 mRNA and CDK1 mRNA in the recurrence group were significantly higher than those in the non-recurrence group,while the level of miR-433-3p was significantly lower(P＜0.05).Logistic regression analysis showed that PGA M1 mRNA(OR=1.387,95％CI,1.025 to 1.877),miR-433-3p(OR=0.543,95％CI,0.319 to 0.924),and CDK1 mRNA(OR=1.353,95％CI,1.108 to 1.651)were all independent factors associated with recurrence and metastasis after laparoscopic surgery for CRC(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)for the combined pre-diction of recurrence and metastasis after laparoscopic surgery for CRC by PGAM1 mRNA,miR-433-3p,and CDK1 mRNA was 0.904(95％CI,0.836 to 0.950),which was superior to the predictive per-formance of each indicator alone.Individual value prediction results indicated that CRC patients would experience early recurrence and metastasis after laparoscopic surgery under the condition of a diagnostic accuracy rate of 84.17％.External validation showed that the Kappa value between the combined prediction result and the actual clinical result was 0.864(95％CI,0.611 to 0.984),in-dicating good consistency.Conclusion The expression levels of PG AM1,miR-433-3p,and CDK1 in surgical specimens are all independent factors influencing early recurrence and metastasis after laparoscopic surgery for CRC patients,and their combined detection has high predictive value for postoperative recurrence and metastasis.

Objective To analyze the correlation between different types of anemia(small cell anemia and nor-mal cell anemia)before operation and pathological features and prognosis of colorectal cancer patients.Methods The clinical data of 130 patients with colorectal cancer who underwent radical surgery in our hospital from March 2018 to February 2021 were retrospectively analyzed.According to the morphology of red blood cells,the patients were divided into group A(70 cases without anemia),group B(18 cases with small cell anemia)and group C(42 cases with normal cell anemia).Pathological features and postoperative 2 a survival rate of the 3 groups were compared.The correlation between preoperative anemia types and pathological features of colorectal cancer was analyzed by Phi coefficient test,and Kaplan-Meier survival curve was drawn to compare the survival rate of the 3 groups.Results There were significant differences in gender,tumor site,tumor diameter and TNM stage distribution among the three groups(P<0.05).The Phi coefficient test showed that preoperative anemia type was correlated with gender,tumor site,tumor diameter,and TNM stage(r = 0.238,0.255,0.266,0.331,P = 0.025,0.015,0.010,0.001).Multivariate Logistic regression analysis showed that tumor diameter≥5 cm,TNM stage Ⅲ-Ⅳ,distant metastasis,lymph node metastasis,preoperative small cell anemia,preoperative normal cell anemia were the risk factors for the prognosis of colorectal cancer after radical surgery(OR>1,P<0.05).The overall survival rate of 2a in group A was higher than that in group C>that in group B(P<0.05).Log-rank test showed that the postoperative survival rate of the three groups was significantly different(P<0.05).Conclusion Preoperative anemia types were correlated with tumor site,tumor diameter,TNM stage and postoperative survival time of colorectal cancer patients,among which preoperative small-cell anemia patients had the lowest survival rate.

Objective To evaluate the effect of LEARNS[listen(L),establish(E),adopt(A),reinforce(R),name(N),strengthen(S)]model health education for patients with peripherally inserted central catheter(PICC)after discharge.Methods From June 2020 to June 2021,193 discharged patients with PICC were selected as the study objects.They were divided into observation group(95 cases)and control group(98 cases)according to random number table method.The control group received routine health education and continued follow-up for 3 months.In the observation group,health education was constructed and implemented at 2,4,8 and 12 weeks after discharge based on the control group and the basis of LEARNS model.The incidence of PICC-related complications and PICC-related adverse events were compared between the two groups,and self-management ability was evaluated using cancer patients PICC self-management scale(CPPSMS)score,strategies used by people to promote health(SUPPH)were used to evaluate self-efficacy.Results The incidence of PICC-related complications and adverse events in the observation group were significantly lower than those in the control group[11.58%(11/95)vs.40.82%(40/98)and 6.32%(6/95)vs.22.45%(22/98),both P＜0.05].There were no statistically significant differences in CPPSMS scores(daily catheter observation,maintenance compliance,management confidence,anomaly handling,information acquisition,tubeed exercise,and tubeed daily life)and SUPPH scores(positive attitude,self-stress reduction,and self-decision-making)in the two groups before intervention,and the above scores were higher than those before intervention.After intervention,the above scores in the observation group were significantly higher than those in the control group(CPPSMS total score was 131.37±27.20 vs.92.41±23.89,daily catheter observation score was 26.02±6.04 vs.18.27±5.43,maintenance compliance score was 18.45±4.36 vs.13.28±3.12,and management confidence score was 17.69±3.37 vs.13.81±3.65,anomaly processing score was 15.01±3.46 vs.10.25±2.74,information acquisition score was 11.98±2.56 vs.7.84±2.07,tube motion score was 15.94±3.46 vs.10.28±2.78,daily life with tubes score was 26.28±5.19 vs.18.68±4.46,all P＜0.05;SUPPH total score was 106.54±20.84 vs.93.93±18.50,positive attitude score was 56.89±11.45 vs.49.34±10.56,self-stress reduction score was 38.25±8.73 vs.34.76±6.28,the self-decision-making score was 11.40±2.57 vs.9.83±2.96,all P＜0.05).Conclusion The implementation of health education based on LEARNS model in discharged patients with PICC tube can improve their self-management ability and self-efficacy,and improve clinical prognosis.