Objective To explore the nutritional status and immune function of hospitalized patients with decompensated cirrhosis.Methods A total of 132 patients with decompensated cirrhosis who were hospi-talized in this hospital from January 2020 to June 2022 were selected.According to Nutritional Risk Screening 2002 (NRS2002) score,the patients were divided into the high-nutritional-risk group,the low-nutritional-risk group,and the non-nutritional-risk group.Comparative analysis was conducted on nutritional status indica-tors,cellular immune indicators,Child-Pugh classification of liver function,and complications among the three groups.Results BMI,TSF,AMC,Hb,ALB,PA,RBP and TG in the high-nutritional-risk group and low-nu-tritional-risk group were lower than those in the non-nutritional-risk group.BMI,TSF,and AMC in the low-nutritional-risk group were lower than those in the non-nutritional-risk group.ALB and TG in the high-nutri-tional-risk group were lower than those in the low-nutritional-risk group,with statistically significant differ-ences (P<0.05).The immune indexes IgG and IgA in the high-nutritional-risk group and the low-nutritional-risk group were higher than those in the non-nutritional-risk group,with statistically significant differences (P<0.05).The percentage of CD4+T cells and the ratio of CD4+T cells to CD8+T cells (CD4+T/CD8+T) in the high-nutritional-risk group and the low-nutritional-risk group were lower than those in the non-nutrition-al-risk group,with statistically significant differences (P<0.05).The NRS2002 score was negatively correla-ted with BMI,TSF,AMC,Hb,ALB,PA,RBP,TC,TG,CD4+T,CD4+T/CD8+T (P<0.05).It was positive-ly correlated with IgG,IgA,IgM (P<0.001).Multivariate stepwise regression analysis showed that there was a linear regression relationship between Hb,TSF,AMC,ALB,RBP,and NRS2002 score.Conclusion The nu-tritional status and immune function of patients with high nutritional risk decompensated cirrhosis are poor.It is necessary to carry out nutritional intervention in patients with high nutritional risk decompensated cirrhosis in time.

Breast cancer has become the malignant tumor with the highest incidence rate among women, of which human epidermal growth factor receptor 2 (HER2) positive breast cancer accounts for about 15%-20%. With the development of anti HER2 targeted drugs, the survival and prognosis of HER2 positive breast cancer has significantly benefited. About 45%-55% of breast cancer patients have low HER2 expression, and these patients usually do not receive anti HER2 treatment. However, there is a significant difference between the biological behavior and prognosis of breast cancer with low HER2 expression and breast cancer with zero HER2 expression. It is helpful to differentiate and adopt corresponding treatment strategies to improve the prognosis of patients. At present, there have been many advances in targeted therapy of breast cancer with low HER2 expression, which provides a useful reference for precision treatment of breast cancer with low HER2 expression.

Objective:To investigate the relationship between peritoneal thickness and baseline solute transport function in peritoneal dialysis (PD) patients, and analyze the factors affecting the function of peritoneal transport.Methods:Non-diabetic end-stage renal disease (ESRD) patients admitted to the Second Hospital of Longyan City from January 2017 to June 2019 were enrolled in this study. The thickness of the peritoneal membrane was measured by color ultrasound instrument before the peritoneal catheterization. Standard peritoneal equilibration test (PET) was performed after one month of peritoneal dialysis. The ratio of corrected creatine in 4 h dialysate to 2 h serum creatine (D/Pcr) was used as a solute baseline transport index, and according to the D/Pcr evaluation results, the patients were divided into high/high average transfer (H) group (D/Pcr≥0.65) and low/low average transfer (L) group (D/Pcr<0.65). The clinical data, peritoneal thickness and peritoneal dialysis related indicators between the two groups of patients were compared. Binary logistic regression was used to analyze the factors affecting the function of peritoneal transport.Results:The amount of peritoneal ultrafiltration in H group was significantly lower than that in L group, intraperitoneal creatinine clearance (Ccr) and peritoneal thickness were significantly higher than those in L group (both P<0.05). Pearson and Spearman correlation results showed that the thickness of peritoneal membrane positively correlated with D/Pcr ( r=0.673, P<0.05), peritoneal Ccr ( r=0.261, P<0.05), and negatively correlated with ultrafiltration of peritoneal dialysis ( r=-0.365, P<0.05). Partial correlation analysis showed that the peritoneal thickness was positively correlated with the solute transport index D/Pcr ( r=0.539, P<0.05) and the peritoneal Ccr ( r=0.338, P<0.05). Binary logistic regression results showed that peritoneal thickening was a risk factor affecting peritoneal transport function ( OR=1.175, 95% CI 1.009-1.369, P<0.05). Conclusions:There is a positive correlation between the peritoneal membrane thickness and the baseline solute transport index in patients with non-diabetic peritoneal dialysis. Peritoneal thickening is a risk factor affecting peritoneal transport function.

Objective:To quantify the kinematic changes in the gait cycle among youths with chronic, nonspecific low back pain (CNLBP).Methods:A Qualisys 3D optical motion capture system was used to document the gait kinematics of 11 youths with CNLBP and 11 healthy counterparts. Gait profile scores and movement analysis profiles were then calculated.Results:The young CNLBP subjects exhibited gait abnormalities, as reflected by the significant difference of the gait variable the range of motion of the dominant knee between the CNLBP and healthy groups [(5.66±1.83)° vs (3.64±1.13)°]. Gait profile scores and movement analysis profiles are applicable to evaluating them.Conclusions:There manifested gait abnormalities in youth CNLBP patients. Gait profile scores and movement analysis profiles are applicable to evaluating them.

OBJECTIVETo explore the feasibility and clinical significance of precision low inferior mesenteric artery (IMA) ligation with the left colonic artery (LCA) preservation and root lymph node dissection in laparoscopic radical resection for rectal cancer, according to the inferior mesenteric artery (IMA) types.

METHODSOne Hundred and fore cases of rectal cancer patients who underwent laparoscopic resection in The Sixth Affiliated Hospital of Sun Yat-sen University from October 2015 to June 2016 were selected and divided into study group and control group according to different surgical methods. The study group (52 cases) accepted precision low IMA ligation with the LCA preservation and root lymph node (No.253) dissection, according to the IMA types and length examined by preoperative computed tomography angiography (CTA) reconstruction. The control group (52 cases) accepted the traditional high IMA ligation. The perioperative efficacy indexes and postoperative recovery situation of the two groups were compared.

RESULTSThe IMA types, IMA length and preoperative clinical stages were not significantly different between the two groups (all P>0.05). The surgery was completed smoothly for patients in both groups, with no conversion to open surgery. But two patients in the study group underwent left colonic artery ligation for intra-operative need. There were no significant differences in the operative time, intra-operative blood lose, the rate of protective ileostomy and post-operative pathological stages between the two groups (all P>0.05). More total lymph nodes [(24.9±5.7) vs. (16.9±4.2), P=0.001] and No.253 lymph nodes [(2.4±1.1) vs. (1.5±0.8), P=0.001] were harvested in study group as compared to control group. However, the positive rate of total harvested lymph nodes and No.253 lymph nodes between the two groups were not significantly different (P>0.05). There were no significant differences between the two groups in postoperative first anal exhaust time, postoperative hospital stay, total volume of postoperative intraperitoneal drainage, postoperative abdominal drainage tube retention time, postoperative anal drainage tube retention time and postoperative catheter retention time (All P>0.05). There were 2 cases of postoperative dysuria and 1 case of anastomotic bleeding in study group. There were 3 cases of postoperative dysuria and 2 cases of anastomotic leak in control group. Less postoperative complications (5.8% vs. 9.6%, P<0.05) in study group as compared to control group. There was no rehospitalization or death case in two groups within 30 days after operation.

CONCLUSIONSIn the laparoscopic radical resection of rectal cancer, preserving LCA and cleaning the root lymph nodes according to IMA types, which could increase the number of harvested lymph nodes and reduce the postoperative complications was safe and effective.

Liver metastasis is the most common cause of death for patients with colorectal cancer.Surgical resection is the first choice for colorectal cancer liver metastasis (CRLMs),but only 10％-25％ of them are resectable.Patients with unresectable CRLMs are usually treated with systemic chemotherapy and/or local ablative therapies as alternative options.The safety and efficiency of thermal ablation therapies have been improved in recent years.The 5-year survival rate of patients underwent thermal ablation is higher than that of patients underwent chemotherapy for treating CRLMs.A consensus for thermal ablation of colorectal liver metastasis was provided by international experts panel on 2013.The recommendations and indications of thermal ablation for CRLMs were considered and documented according to the literature review based on radiofrequency ablation with long-term follow-up.The main content of the consensus from international experts for thermal ablation of colorectal liver metastasis were reviewed in this article.

A rapid quantitative evaluation method for Siraitia grosvenorii cells was successfully developed based on plant cells' capacitance value detected by a viable cell mass monitor and the cryopreservation of S. grosvenorii suspension cells was optimized. The survival rate of S. grosvenorii cells was quantitatively measured by viable cell mass monitor and 2, 3, 5-triphenyltetrazolium chloride (TTC). An optimum cryoprotectant recipe is that the growth medium contained 10% sucrose and 10% DMSO. The experimental results also showed higher cell survival rates and cell viabilities were achieved when suspension cells were treated with pretreatment of 0.2 mol/L sucrose. With the increase of concentration of sucrose, however, the cell survival rate was decreased. And the cell survival rate represented a bell shape with the increase of pretreatment time. The highest cell survival rate and cell viability were obtained with the 9 h' s pretreatment. In addition, there was a good correlation between the cell survival rate measured by cell recovery test and that measured by viable cell mass monitor, while there were no significant differences in the cell morphology and the ability of mogrosides V production by S. grosvenorii cells cultured in suspension after cryopreservation. Therefore, the evaluation method developed based on the viable cell mass monitor has good feasibility and reliability.

OBJECTIVETo study the impact of neoadjuvant radiochemotherapy on erectile and urinary functions in mid-low rectal cancer patients.

METHODSSeventy mid-low rectal cancer patients from January 2012 to May 2013 in The Sixth Affiliated Hospital, Sun Yat-sen University were prospectively enrolled. According to tumor staging and patient decision, patients received neoadjuvant radiochemotherapy(50 Grays administered over a six-week period and four cycles of concomitant mFOLFOX6 chemotherapy followed by operation (study group) or surgery alone(control group). Dropouts, loss to follow up and relapse during follow-up were removed from the analysis. A total of 30 patients stayed in study group and 29 patients in control group. To assess erectile and urination functions, the five-item version of the international index of erectile function (IIEF-5) and the international prostate symptom score (IPSS) questionnaires were used before therapy and 12 months after surgery.

RESULTSIn both study and control groups, total IIEF-5 score was decreased significantly at postoperative 12-month compared to initial assessment(P<0.01). Compared with control group, IIEF-5 score change was significantly higher in study group (9.6 ± 6.1 vs. 5.3 ± 5.3; P<0.01). Total IPSS score in both groups was increased significantly at postoperative 12-month compared to initial assessment(P<0.05). No significant difference was found in IPSS score change between the two groups (3.0 ± 3.4 vs. 1.5 ± 3.0, P>0.05). Univariate analysis on study group showed that age, tumor location and maximal diameter were associated with erectile dysfunction. Age was associated with urination dysfunction (all P<0.05).

CONCLUSIONNeoadjuvant radiochemotherapy has significant impact on erectile dysfunction after surgery in mid-low rectal cancer patients.

Chemoradiotherapy ; Erectile Dysfunction ; Humans ; Male ; Neoadjuvant Therapy ; Neoplasm Staging ; Prospective Studies ; Rectal Neoplasms ; Surveys and Questionnaires ; Urinary Incontinence

OBJECTIVETo evaluate the influences of inferior mesenteric artery (IMA) types and Riolan artery arcade absence on the incidence of anastomotic leakage(AL) after laparoscopic resection of rectal cancer.

METHODSClinical data of 116 local advanced rectal cancer patients who underwent laparoscopic resection in The Sixth Affiliated Hospital of Sun Yat-sen University from January 2012 to December 2014 were analyzed retrospectively. IMA and Riolan artery arcade were examined by preoperative computed tomography angiography (CTA) reconstruction. The influences of IMA type, Riolan artery arcade absence and ligation site (high or low) on AL were analyzed by Logistic regression.

RESULTSThe proportion of IMA types(I(-IIII() was 57.8%(67/116), 10.3%(12/116), 31.0%(36/116) and 0.9%(1/116), respectively. Riolan artery arcade absence was found in 60.3%(70/116). Eight (6.9%) patients suffered from AL. IMA type III( had significantly higher AL incidence as compared to other IMA types [19.4%(7/36) vs. 1.2%(1/80), P=0.001]. Meanwhile, patients with Riolan artery arcade absence also had significantly higher AL incidence[11.4%(8/70) vs. 0.0%(0/46), P=0.030]. However, the difference in AL incidence between high and Low IMA ligation was not statistically significant [8.0%(7/87) vs. 3.4%(1/29), P=0.531]. Seven of these 8 AL patients were found in IMA type III( with Riolan artery arcade absence and high ligation. Multivariate analysis showed that IMA type III( (P=0.001) and Riolan artery arcade absence (P=0.002) were independent risk factors of AL.

CONCLUSIONSIMA type III( with Riolan artery arcade absence increases AL incidence significantly in laparoscopic resection of rectal cancer. IMA type and Riolan aretry arcade absence or not contribute to the selection of IMA ligation site in the operation. For the colorectal cancer patients with IMA type III( and Riolan artery arcade absence, selective low IMA ligation with root lymph node dissection should be recommended.

Adult ; Anastomotic Leak ; Arteries ; Colorectal Neoplasms ; surgery ; Female ; Humans ; Incidence ; Laparoscopy ; Ligation ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Mesenteric Artery, Inferior ; Middle Aged ; Rectal Neoplasms ; surgery ; Retrospective Studies

OBJECTIVETo compare two different routes of totally implantable venous access ports (TIVPs) from the upper arm vein and the subclavian vein in terms of complications for patients with gastrointestinal malignancy.

METHODSPatients who underwent implantations of TIVPs from September 2013 to January 2015 were retrospectively evaluated. The outcome measurements were rates and types of postprocedural early-stage and long-term complications.

RESULTSA total of 208 patients(upper arm vein group, 86; subclavian vein group, 122) were included in this study. All TIVPs were implanted successfully. The rate of catheter displacement was higher in upper arm vein group(14.0% vs 5.7%, P=0.04), while other postprocedural early-stage complications had no significant difference between the two groups. The occurrence of transfusion obstacle and rates of overall postprocedural long-term complications were significantly lower in upper arm vein group than that in subclavian vein group(1.2% vs. 9.8%, P=0.02; 7.0% vs. 27.0%, P=0.01, respectively).

CONCLUSIONCompared with subclavian vein group, upper arm vein group has lower postprocedural long-term complication rates and is recommended as a safe and comfortable choice for port implantation.