Objective To evaluate the efficacy and safety of polyethylene glycol electrolyte powder(PEG)combined with linaclotide(Lin)for bowel preparation in elderly constipated patients before colonoscopy.Methods In this prospective,randomized controlled trial,90 elderly patients with constipation undergoing colonoscopy were recruited at our hospital from June 2022 to December 2023.Participants were randomly assigned to three groups(n=30 each):PEG-3L alone,PEG-3L+Lin,and PEG-2L+Lin.Primary outcome was Boston Bowel Preparation Scale(BBPS)score and secondary outcomes included adverse event rates,colonoscopy completion rate,withdrawal time,and polyp detection rate.Statistical analysis was performed using independent t-tests and chi-square tests.Results The PEG-3L+Lin group achieved significantly higher BBPS scores than both PEG-3L alone and PEG-2L+Lin groups did(both P<0.001).The PEG-2L+Lin group also outperformed the PEG-3L alone group in cleansing efficacy(90.0%vs.76.7%,P=0.008).The PEG-2L+Lin group demonstrated the best tolerability and lowest adverse event rate,the PEG-3L group had the longest withdrawal time(P<0.05),but the three groups showed no significant difference in polyp detection rates.Conclusion PEG combined with linaclotide significantly improves bowel cleansing in elderly constipated patients.PEG-2L+Lin regimen provides optimal balance between efficacy,safety,and tolerability,making it a preferable choice for this population.

Objective To explore the relationship between the oral health status with the severity and outcome of pediatric bronchopneumonia.Methods A total of 150 children patients with bronchopneumonia admitted and treated in this hospital from January 2020 to August 2022 were selected as the observation group(n=150).According to the severity of the illness,the children patients were divided into the mild group(n=97)and severe group(n=53).In addition,150 children undergoing physical examination during the same pe-riod were selected as the control group(n=150).The changes in the decay missing filling surface(DMFS),simplified oral hygiene index(OHI-s)and plaque index(PLI)were analyzed.Spearman was used to analyze the relationship between the oral health status and the severity of bronchopneumonia.After one month of treatment,the changes in oral health status were analyzed under different outcome conditions.The receiver op-erating characteristic(ROC)curve was drawn to assess the predictive effect of the oral health status on the outcome of pediatric bronchopneumonia.Results The DMFS,OHI-s scores and PLI scores in the observation group were higher than those in the control group(P＜0.05).The DMFS,OHI-s score and PLIscores in the severe group were higher than those in the mild group(P＜0.05).Spearman analysis found that DMFS,OHI-s and PLI were positively correlated with the severity(r=0.441,0.253,0.328,P＜0.05).The levels of DMFS,OHI-s and PLI in the poor prognosis group were higher than those in the good prognosis group(P＜0.05).The area under the curve(AUC)of DMFS,OHI-s and PLI combination in predicting the outcome of bronchopneumonia was 0.851(0.703～0.999),with a sensitivity of 83.78％and a specificity of 92.92％.Con-clusion The oral health status is closely related to the severity of pediatric bronchopneumonia,which can be used to assess the outcome of the children patients.

Objective To evaluate the efficacy and safety of polyethylene glycol electrolyte powder(PEG)combined with linaclotide(Lin)for bowel preparation in elderly constipated patients before colonoscopy.Methods In this prospective,randomized controlled trial,90 elderly patients with constipation undergoing colonoscopy were recruited at our hospital from June 2022 to December 2023.Participants were randomly assigned to three groups(n=30 each):PEG-3L alone,PEG-3L+Lin,and PEG-2L+Lin.Primary outcome was Boston Bowel Preparation Scale(BBPS)score and secondary outcomes included adverse event rates,colonoscopy completion rate,withdrawal time,and polyp detection rate.Statistical analysis was performed using independent t-tests and chi-square tests.Results The PEG-3L+Lin group achieved significantly higher BBPS scores than both PEG-3L alone and PEG-2L+Lin groups did(both P<0.001).The PEG-2L+Lin group also outperformed the PEG-3L alone group in cleansing efficacy(90.0%vs.76.7%,P=0.008).The PEG-2L+Lin group demonstrated the best tolerability and lowest adverse event rate,the PEG-3L group had the longest withdrawal time(P<0.05),but the three groups showed no significant difference in polyp detection rates.Conclusion PEG combined with linaclotide significantly improves bowel cleansing in elderly constipated patients.PEG-2L+Lin regimen provides optimal balance between efficacy,safety,and tolerability,making it a preferable choice for this population.

Objective:To investigate the role of kinesin family proteins(KIF)2C in chemoresistance of epithelial ovarian cancer and its potential molecular mechanism.Methods:The differential expression of KIF2C in cisplatin-sensitive cell line A2780 and cisplatin-resistant cell line A2780DDP was detected.Different concentrations and time of cisplatin were added to A2780 cell line to detect the differential expression of KIF2C.The ovarian cancer cell line KIF2C-OV with stable overexpression of KIF2C was constructed by lentivirus infection of A2780DDP cell line.The same concentration of cisplatin was added to KIF2C-OV and its control group(Ctrl-OV)cell lines.The effect of KIF2C overexpression on the proliferation of drug-resistant cell line A2780DDP was detected by Cell Counting Kit-8(CCK-8). Finally, the molecular mechanism of KIF2C resistance in ovarian cancer cell lines was preliminarily explored.Results:KIF2C was significantly down-regulated in A2780DDP cells.After cisplatin was added to A2780 cell line, the expression of KIF2C decreased with the increase of cisplatin concentration and action time.The ovarian cancer cell line KIF2C-OV with stable overexpression of KIF2C was constructed by lentivirus infection of A2780DDP cell line.After adding cisplatin, the proliferation ability of KIF2C-OV cell line was significantly lower than that of Ctrl-OV cell line.The expression of p-Erk was increased in A2780DDP cell line.The expression of p-Erk in A2780 cell line was increased with the increase of cisplatin concentration and time.After overexpression of KIF2C in A2780DDP ovarian cancer cell line, the expression level of p-Erk decreased.Conclusions:KIF2C may be a potential target gene of chemotherapy resistance in ovarian cancer, which may play its role through MAPK/ERK pathway.

Objective:To analyze the efficacy of the enhanced recovery after surgery(ERAS)approach in endometrial cancer patients treated with surgical staging and its beneficial effects on the oxidative stress response.Methods:Eight-two endometrial cancer patients treated with surgical staging at our hospital between March 2020 and March 2022 were recruited and divided into different groups using a computer-generated random number table, with 41 in the control group who were given routine intervention and 41 in the observation group receiving ERAS.Results:About perioperative performances, the oxidative stress response, inflammatory factor levels and complications were compared between the two groups.Results in the observation group, the intraoperative body surface temperature was higher than in the control group[(36.71±0.22)℃ vs.(36.20±0.21)℃, t=10.737, P=0.000], and the time from the end of surgery to first water intake[(4.41±1.30)h vs.(6.79±1.28)h, t=8.353, P=0.000], to first food intake[(7.86±1.35)h vs.(12.88±2.57)h, t=11.073, P=0.000], to first ambulation[(12.92±3.11)h vs.(24.24±5.06)h, t=12.204, P=0.000], to first flatus[(24.11±4.96)h vs.(35.13±6.20)h, t=8.887, P=0.000], to first bowel movement[(2.67±0.63)d vs.(4.03±1.15)d, t=6.641, P=0.000]and the length of hospitalization[(3.31±1.25)d vs.(5.77±1.59)d, t=7.788, P=0.000]were shorter than in the control group.On the third day after surgery, the levels of malondialdehyde[(77.96±7.62)μmol/L vs.(90.16±7.88)μmol/L, t=7.126, P=0.000], advanced oxidation protein products[(33.16±4.75)μmol/L vs.(43.55±5.37)μmol/L, t=9.280, P=0.000], CAT[(22.59±3.01)U/ml vs.(25.12±3.3)U/ml, t=3.609, P=0.000]and reactive oxygen species[(74.13±5.02)pmol/L vs.(90.33±5.89)pmol/L, t=13.404, P=0.000]in the two groups were higher than those on the day before surgery, but were lower in the observation group than in the control group at the same time points after surgery.On the 3rd day after surgery, the levels of Tumor Necrosis Factor-α, C-reactive protein and interleukin 6 in the two groups were higher than those on the day before surgery, but were lower in the observation group than in the control group at the same points after surgery(all P<0.05). In the observation group, the incidence of complications was 14.63%, lower than 39.02% in the control group( χ2=6.212, P=0.013). Conclusions:The ERAS approach can achieve significant results in endometrial cancer patients treated with surgical staging.It can not only improve perioperative performance, relieve oxidative stress and lower inflammatory factor levels, but also effectively prevent complications.

Objective:To investigate the effects and mechanism of cystostomy on young rats′ bladders function.Methods:Eighty female SD rats were divided into cystostomy group, sham operation group (the two groups included day 1, 3, 5 after operation), control group(it included day 1, 3, 5 after operation) and medicine intervention group by using random number table, there were 8 rats in each group.Cystometry was conducted in cystostomy group (day 1, 3, and 5 postoperative subgroup), and voided interval (VI), voided volume (VV), postvoid residual urine (PVR), bladder capacity (BC), maximum bladder pressure (Pves.max), bladder threshold pressure (Pves.thr), and bladder compliance(△C) were recorded.The rats in sham operation and control groups voided freely in the condition of diuresis by intravenous infusion saline, and VV, PVR and BC were recorded.Bladders′ tissues were collected for HE staining and histopathological inflammation scores (HIS) after urodynamic investigations.In medicine intervention group, different doses of anisodamine were applied and the changes of VI, VV, PVR, BC, Pves.max and Pves.thr were observed.Results:The trend of VV, VI, BC and △C was upwards on days 1, 3, and 5 postcystostomy.Meanwhile, compared with control group [VV: (1.408±0.033) mL, BC: (1.411±0.032) mL], VV and BC on day 1 and 3 postcystostomy were less[VV: (0.288±0.059) mL, (0.598±0.154) mL; BC: (0.292±0.059) mL, (0.601±0.154) mL]. There were statistically significant differences ( P<0.05). However, VV, PVR and BC on day 5 postcystostomy were not different from that of control group(all P>0.05). HE staining demonstrated that the HIS of days 1 and 3 postcystostomy and day 1 post-sham operation were in severe inflammatory phase, with HIS >4 scores.Additionally, the inflammation on day 5 in cystostomy group and days 3-5 in sham operation group were mild (HIS<2 scores). The correlation test of BC and HIS was negative( r=-0.880, P<0.001). After the application of anisodamine on dose of 0.2 mg/kg, VI, VV and BC of the young rats on day 3 postcystostomy significantly increased, compared with those before intervention [(643.500±65.889) s, (1.073±0.110) mL, (1.076±0.110) mL vs.(367.938±77.697) s, (0.612±0.129) mL, (0.617±0.129) mL, all P<0.05], while PVR, Pves.max and Pves.thr did not significantly change compared with those before intervention. Conclusion:The recent abnormal changes of urodynamics postcystostomy were related to the traumatic acute bladder inflammation in the young rats.On day 5 after the surgery, the bladder function basically returned to normal with the regression of the acute bladder inflammation.Anisodamine at 0.2 mg/kg dose could effectively relieve the symptoms of overactive bladder postcystostomy.

Objective:To investigate whether Losartan can inhibit the formation of ascites in a nude mouse model of ovarian cancer by improving lymphatic drainage.Methods:Eight-week-old nude mice were randomly divided into 3 groups with 24 mice in each group.The blank control group received no treatment.Mice in the other two groups were given orthotopic transplantation of SKOV3 IP1-Gluc human ovarian cancer cells.Peritoneal tumor growth was monitored by peripheral blood Gluc levels, and mice were enrolled when the blood Gluc level reached 1×10 6 relative light units.Twenty-two nude mice were in the control group and 23 in the Losartan treatment group.Mice were sacrificed on the 28 th day after cancer cell implantation.Tumor tissues and diaphragm were removed, and the volume of ascites was measured after suction.Sirius Red, αSMA and Collagen 1 staining were used to detect the contents of extracellular matrix collagen and fibroblasts.Lymphangiography was used to examine the diaphragmatic lymphatic morphology, and intraperitoneal injection of fluorescent microspheres was used to visualize the distribution of fluorescent microspheres in diaphragmatic and mediastinal lymph nodes to estimate the function of diaphragmatic lymphatic drainage. Results:Losartan treatment significantly reduced the formation of ascites in the nude mouse model of ovarian cancer( P<0.05). Intratumoral contents of collagen(sirius red positive area, Collagen 1 content)and fibroblasts(αSMA positive area)were significantly reduced in the Losartan treatment group(all P<0.05). Compared with normal nude mice, the diaphragm lymphatic vessels were dilated and the structure was disordered in the control group.In the Losartan treatment group, the morphology and distribution of lymphatic vessels in the diaphragm improved and tended to normalize, as did the drainage function of lymphatic vessels. Conclusions:Losartan can inhibit the formation of extracellular matrix, reduce the extracellular matrix content of ovarian cancer cells, reduce solid pressure, relieve the oppressive effect on lymphatic vessels, improve lymphatic drainage and reduce ascites formation.

OBJECTIVETo study the effect of neoadjuvant chemotherapy on nutritional status in patients with locally advanced gastric cancer.

METHODSCases inclusion criteria: (1)18-65 years old; (2) Gastric cancer confirmed by gastroscopic biopsy; (3) Preoperative TNM stage III( according to the AJCC stage 2000 standard; (4) Kamosfsky functional status score> 60 points; (5)Receiving neoadjuvant chemotherapy voluntarily and signing the informed consent form. Case exclusion criteria: (1)Having contraindications of chemotherapy and surgery; (2) Suffering from heart, liver and kidney and other underlying diseases; (3) Concurrent with malignant diseases, wasting disease or other digestive diseases. According to the above criteria, clinical data of 73 patients of stage III( gastric cancer receiving neoadjuvant chemotherapy at Weifang People's Hospital from May 2015 to March 2017 were prospectively collected. The cohort study was adopted. After removing 3 patients who did not complete the chemotherapy, a total of 70 patients who completed the chemotherapy were included in the study. All the patients received SOX chemotherapy without nutritional support during chemotherapy. Changes of body composition and nutritional indicators were analyzed before and after chemotherapy, and according to the tumor regression after chemotherapy, patients were divided into response group (complete or sub-total tumor regression) and non-response group (tumor part, with or without a small amount of retreat) for stratified analysis.

RESULTSOf 70 gastric cancer patients, 40 were male and 30 were female with a age of (53.8±6.4) (28 to 64) years. There were 26 cases (37.1%) of stage III(a, 35 cases (50.0%) of stage III(b and 9 cases (12.9%) of stage III(c. There were 41 cases in response group and 29 cases in non-response group. Three patients (4.3%) were complete remission (CR) and 38 patients (54.3%) were partial remission (PR) in response group, while 23 cases (32.9%) were stable disease (SD) and 6 cases (8.6%) were progressive disease (PD). After neoadjuvant chemotherapy, the extracellular fluid of the whole patients increased from (13.3±1.7) L to (13.5±1.6) L (t=-2.044, P=0.045); the intracellular fluid decreased from (21.4±2.5) L to (21.1±2.4) L (t=2.369, P=0.021); the lymphocyte count decreased from (0.31±0.10)×10/L to (0.29±0.10)×10/L (t=1.706, P=0.009); the other indexes were not significantly different (all P>0.05). Stratified analysis showed that after neoadjuvant chemotherapy in response group, body mass increased from (60.1±8.8) kg to (61.0±8.3) kg (t=-2.773, P=0.008); body mass index increased from (21.9±2.4) kg/m to (22.3±1.9) kg/m(t=-3.479, P=0.001), while above two parameters did not differ significantly in non-response group. No significant differences in body mass, body mass index, skeletal muscle, inorganic salt, extracellular fluid, body fat, protein, upper arm circumference and intracellular fluid were found between two groups before and after neoadjuvant chemotherapy(all P>0.05). Except slight decrease in hemoglobin and lymphocyte, the other nutritional indicators were slightly elevated in response group, while the differences were not statistically significant(all P>0.05). All nutritional indicators in non-response group were slightly decreased without significant differences as well (all P>0.05).

CONCLUSIONNeoadjuvant chemotherapy does not aggravate malnutrition in patients with locally advanced gastric cancer.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Chemotherapy, Adjuvant ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Nutritional Status ; Remission Induction ; Stomach Neoplasms ; drug therapy

Objective To investigate the effect of surgical treatment on survival in colorectal carcinoma patients with synchronous hepatic metastasis.Methods The retrospective case-control study was done on 953 consecutive patients with synchronous colorectal hepatic metastasesl from January 2003 to December 2013.Results Median survival time (46.7 months)and 5-year survival rate (32％) for patients with resected hepatic metastases was significantly superior to that of with nonoperative treatment (17 months,4％).Expanded criteria for hepatic metastases resection raised resection rates (31％ vs.13.6％,P ＜0.05).For patients with resectable hepatic metastases,the inhospital cost for simultaneous resection group was lower than that in the staged resection group (36 698 vs.45 134 RMB,P ＜ 0.05).For patients of asymptomatic primary tumor with unresectable hepatic metastases,resection of the primary tumor was associated with an improved median survival (18.0 vs.15.0 months,P ＜ 0.05) Conclusions Expanding indications of hepatic metastases resection can improve survival in patients with synchronous colorectal hepatic metastases.Simultaneous resection of primary tumor and hepatic metastases were indicated in patients with resectable synchronous colorectal hepatic metastases.Resection of primary tumor was recommended for asymptomatic patients with unresectable hepatic metastases.

Objective The objective of this study was to investigate the clinicopathological features and rational treatment of primary fallopian tube cancer(PFTC).Methods The clinical and pathological data of 39 patients with primary fallopian tube cancer from January 2006 to July 2016 in Beijing Tongren Hospital of Capital University were retrospectively analyzed.Results There were 39 cases of undifferentiated carcinoma,including 1 case of undifferentiated and transitional cell carcinoma,37 cases of undifferentiated adenocarcinoma,or 29 cases of simple adenocarcinoma and 10 cases of mixed type.Among them,7 cases were treated with clear cell carcinoma,endometriosis in 2 cases,combined with transitional cell carcinoma in 1 case.Extra-pelvic metastases were the most common site of the omentum with 17 cases.The preoperative test CA125 was increased in 13 cases and 38 patients received postoperative chemotherapy.The 5-year overall survival rate of 39 patients was 51.3%.Univariate analysis showed that postoperative pathologic stage(Ⅰ~Ⅱ vs.Ⅲ,P<0.001),intraoperative residual lesion size(P<0.001),omentum metastasis(P<0.001),ovarian metastasis(P=0.034),retroperitoneal lymph node metastasis(P=0.018)and preoperative CA125 elevation(P=0.002)were associated with prognosis,while age(P=0.310)and pathological grade(P=0.663)were not associated with prognosis.Multivariate analysis showed that the number of patients with postoperative lymph node metastasis(P=0.018)and preoperative CA125 elevation(P=0.002)were correlated with prognosis(HR=1.202,95% CI:2.354~63.290,P=0.003) and pathological stage(HR=3.810,95% CI:1.202~12.079,P=0.023).They were associated with prognosis as independent prognostic factors.Conclusion Tumor pathologic staging and omentum metastasis are important prognostic factors influencing the prognosis of patients with primary fallopian tube cancer.Early diagnosis and complete operation can improve the prognosis of patients.